An exploratory study of the needs of staff who care for offenders with a diagnosis of personality disorder

Abstract

People with a diagnosis of personality disorder who are considered a risk to others are a current concern for public services, government and society. Healthcare provision for this group has recently increased, making it important to begin to learn about the needs of staff working in such a challenging area. An exploratory interview study with staff working in a medium secure unit for offenders with a diagnosis of personality disorder (Unit Z) is presented. Interviews were line-coded and analysed according to the grounded theory method. A model was developed from higher order categories. This related key contextual factors to areas of concern for staff. The key contextual factors were: 'complexity of the task' and 'tension in the relationship with outside'. The areas of concern were: 'desire for more meaningful contact', 'contradictory attitude towards openness', 'feeling physically safe but emotionally vulnerable', 'ambivalence towards structure and control' and 'emphasis on staff relationships'. 'Risk of isolation' formed a core category and described Unit Z staff's pervading sense of distance from the outside world. These categories are described with supporting quotations and discussed in relation to the existing literature. Their implications for clinical practice and the development of services are considered.

‘Everything contradicts in your mind’: A qualitative study of experiences of forensic mental health staff in two contrasting services

“…It has been recognised that it is difficult to identify a primary task in the ‘human services’, where desired outcomes vary greatly between individual staff and different staff groups (Menzies Lyth, 1979; Miller and Rice, 1990; Zagier Roberts, 1994). This may be especially true of FMH services, in which a complex clinical task is set against the background of inherent tension between therapeutic activity and management of risk (Kurtz, 2002, 2007).…”

Admitting offenders with antisocial personality disorder to a medium secure unit: a qualitative examination of multidisciplinary team decision-making

“…Alternatively, and perhaps more importantly, there needs to be a forum for open discussion of differences of opinion arising between members of staff (Kurtz & Turner, 2007). Daykin and Gordon (2011) explore this possibility in a high secure hospital.…”

Researching the psychological therapies in prison: considerations and future recommendations

“…Within classic grounded theory, a series of categories are formed from the data, which are the basis for the creation of a theory (Glaser and Strauss, 1967). A number of grounded theory studies have taken place in relation to the prison with regard to needs of staff who care for offenders with a diagnosis of personality disorder (Kurtz and Turner, 2007), implications of prison on families (Arditti et al, 2003) and transfer in conflict resolution (Apprey, 2005).…”