An Evaluation of New Services for Personality-Disordered Offenders: Staff and Service User Perspectives

Fortune, Zoe; Rose, Diana; Crawford, Mike; Slade, Mike; Spence, Robin; Mudd, David; Barrett, Barbara; Coid, Jeremy W.; Tyrer, Peter; Moran, Paul

doi:10.1177/0020764009105281

Cited by 17 publications

(18 citation statements)

References 10 publications

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“…Qualitative data from this study (Fortune et al, 2010) indicates that engaging in talking treatment can be very stressful for personality-disordered offenders and this may offer one explanation for the high rate of disengagement. Previous research has suggested that offenders who commence a treatment programme, but do not complete it, are at greater risk of recidivism compared to those who never commence treatment (McMurran & Theodosi, 2007).…”

Section: Discussionmentioning

confidence: 81%

Clinical and economic outcomes from the UK pilot psychiatric services for personality-disordered offenders

Fortune

Barrett

Armstrong

et al. 2011

International Review of Psychiatry

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Personality-disordered offenders are difficult individuals to manage, and knowledge about effective treatment is sparse. In the UK, novel forensic psychiatric services were recently established for the treatment of offenders with personality disorder. In this paper we report the clinical and economic findings from a 2-year follow-up of a cohort of service users recruited from these services. Baseline information on developmental, clinical and offending histories was obtained from case records. Case records were checked at 6 and 24 months for new episodes of self-harm, violence, alcohol and substance use, and offending behaviour. Ratings of social functioning and therapeutic alliance were obtained from service users at baseline, 6 and 24 months. Fifty-six percent of service users were still engaged with the services at 24-month follow-up. Service users involved in the greatest number of behavioural incidents had greater impairment in baseline social functioning and lower IQ scores. There was no significant change in either therapeutic alliance or social functioning at 6 or 24 months. The economic analysis showed that although the services were predominantly run by the Health Service, there were considerable economic burdens shared by other service providers. Treatment costs at six-month follow-up were also significantly higher. Implications are discussed.

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Section: Discussionmentioning

confidence: 81%

Clinical and economic outcomes from the UK pilot psychiatric services for personality-disordered offenders

Fortune

Barrett

Armstrong

et al. 2011

International Review of Psychiatry

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“…Challenging and inappropriate behaviour by PDOs was also thought to be draining, stressful and to inspire a degree of fear [ 33 ]. Such behaviour could also lead to splits within the staff team itself [ 34 ] or difficulties with communication [ 35 ] that could deepen over time.…”

Section: Resultsmentioning

confidence: 99%

The Impact on Staff of Working with Personality Disordered Offenders: A Systematic Review

et al. 2015

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BackgroundPersonality disordered offenders (PDOs) are generally considered difficult to manage and to have a negative impact on staff working with them.AimsThis study aimed to provide an overview of studies examining the impact on staff of working with PDOs, identify impact areas associated with working with PDOs, identify gaps in existing research,and direct future research efforts.MethodsThe authors conducted a systematic review of the English-language literature from 1964–2014 across 20 databases in the medical and social sciences.Results27 papers were included in the review. Studies identified negative impacts upon staff including: negative attitudes, burnout, stress, negative counter-transferential experiences; two studies found positive impacts of job excitement and satisfaction, and the evidence related to perceived risk of violence from PDOs was equivocal. Studies demonstrated considerable heterogeneity and meta-analysis was not possible. The overall level of identified evidence was low: 23 studies (85%) were descriptive only, and only one adequately powered cohort study was found.ConclusionsThe review identified a significant amount of descriptive literature, but only one cohort study and no trials or previous systematic reviews of literatures. Clinicians and managers working with PDOs should be aware of the potential impacts identified, but there is an urgent need for further research focusing on the robust evaluation of interventions to minimise harm to staff working with offenders who suffer from personality disorder.

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“…IPA has been widely used by music therapists previously (Pool and Odell-Miller, 2011;Smith, Flowers, & Larkin, 2009;Hervey and Odell-Miller 2013), as well as in 9 the evaluation in mental health research (Fortune et al, 2010).…”

Section: Analysis (Ipa)mentioning

confidence: 99%

An investigation of pivotal moments in music therapy in adult mental health

Gavrielidou

Odell‐Miller

2017

The Arts in Psychotherapy

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This article describes a study that investigated pivotal moments in music therapy in adult mental health settings. A phenomenological qualitative method was used in order to search for answers to the questions for investigation. It included an extensive literature review, regarding pivotal moments from different fields, including music therapy. Three semi-structured interviews with music therapists investigated their experience of pivotal moments, the role function and importance of pivotal moments in music therapy. Detailed information was analysed using Phenomenological Interpretative Analysis (IPA). A case study supports the evidence gathered in the interviews and literature review, and describes the emergence of a pivotal moment and its contribution within a short-term individual music therapy treatment with a man with schizophrenia. Gathered information and results from the interview analysis highlight distinctive characteristics of pivotal moments and their contribution to the patients' lives and therapists' work. Pivotal moments are found to change the music therapy process and lead to a better understanding of the patient. The role of the therapist, the therapist's qualities and basic features or techniques that support the emergence of pivotal moments, are also discussed.

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An Evaluation of New Services for Personality-Disordered Offenders: Staff and Service User Perspectives

Abstract: Forensic PD services may be having an important impact on the quality of service users' lives. Whether treatment is successful in reducing long-term risk to others remains to be seen, and the cost-effectiveness of these services needs to be examined.

Cited by 17 publications

References 10 publications

Clinical and economic outcomes from the UK pilot psychiatric services for personality-disordered offenders

Clinical and economic outcomes from the UK pilot psychiatric services for personality-disordered offenders

The Impact on Staff of Working with Personality Disordered Offenders: A Systematic Review

An investigation of pivotal moments in music therapy in adult mental health

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