Lessons from the front line: working with offenders with learning disability and personality disorder in a high secure therapeutic community

Taylor, John; Trout, Sarah

doi:10.1108/13619321311306974

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Dickens et al 2011). EssenCES has also been used as an outcome measure in evaluation studies (Braham, Heasley, & Akiens, 2013;Kerfoot, Bamford, & Jones, 2012;Livingston, Nijdan-Jones, Lapsley, Calderwood, & Brink, 2013;Taylor & Trout, 2013), but these have not investigated patient features that may be associated with ward climate. A clear picture of the patient-related determinants of ward climate has yet to emerge, in part because studies have defined and measured ward environment differently, sometimes using poorly validated tools and underpowered analyses.…”

Section: Introductionmentioning

confidence: 98%

Associations between ward climate and patient characteristics in a secure forensic mental health service

Dickens

Suesse

Snyman

et al. 2014

The Journal of Forensic Psychiatry & Psychology

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Ward climate is associated with patient satisfaction and, potentially, with improved outcomes but increased understanding of its relationship with individual patient characteristics is required. We investigated relationships between patient (N = 63) gender, perceived risk, risk behaviour, therapeutic engagement (session attendance), psychopathology and ward climate in a forensic psychiatric hospital. Lower security levels were significantly associated with better patient cohesion (PC), experienced safety (ES) and therapeutic hold (TH). Female gender predicted PC and ES. Higher perceived risk was associated with lower PC after controlling for security level and gender. Diagnosis of personality disorder or psychosis was associated with higher ES. Lower levels of engagement predicted greater TH. The relationship between patient characteristics and ward climate in forensic settings is complex. Prospective studies are needed to further establish determinants of ward climate, particularly those aspects of patient risk that are associated with poorer PC.

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Section: Introductionmentioning

confidence: 98%

Associations between ward climate and patient characteristics in a secure forensic mental health service

Dickens

Suesse

Snyman

et al. 2014

The Journal of Forensic Psychiatry & Psychology

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Therapeutic communities for people with intellectual disability and complex needs

Taylor

Crowther

Bryant

2015

Advances in Mental Health and Intellectual Disabilities

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Purpose – The purpose of this paper is to describe the use and value of therapeutic communties (TCs) in services for people with intellectual disabilities (IDs) and complex needs. Design/methodology/approach – A structured literature review of TC in ID services. Findings – TCs have been used in a range of in-patient services for people with IDs. Although outcome studies are scarce, those that exist offer promising indications of such service designs. Originality/value – TCs have seen a recent increase of interest in ID services. This paper provides an overview of these services and outlines the benefits that such a residential culture can offer for both service users and staff members.

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Assessing personality disorder in learning disabled forensic populations: A rapid evidence assessment

Palmer¹,

Miles²,

Davies³

2021

bpsfu

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Purpose:The aim of this rapid evidence assessment (REA) is to evaluate the literature pertaining to the assessment of Personality Disorder (PD) within Learning Disabled (LD) forensic populations. This paper will provide practitioners with recommendations about the administration of PD assessment that can be applied to clinical practice.Design/methodology/approach:Following the refinement of the search terms and a thorough literature search (using databases such as PsychINFO, OVID, SCOPUS), 98 abstracts were read. Through multiple exclusion criteria, seven papers were included in the results section of this paper.Findings:The primary research papers included in this report demonstrated various degrees of interrater reliability, predictive validity and utility for several specific assessments designed to assess PD.Research limitations/implications:There is a paucity of research in this area. It was therefore difficult to obtain primary research about assessing PD within LD populations. Further to this, there was just one paper that compared different diagnostic systems against one another. Therefore, this REA is not considered to be a full evaluation of the entire PD/LD evidence base. As a research method, REA’s are more biased than compared to a systematic review. This is because REA’s conduct limited data extraction and limit the types of research papers that are included meaning the search is not as comprehensive. Finally, there was only one reviewer for this REA. This is a limitation as the appraisal and selection of the research for this paper was not blind.Social implications:There are ethical concerns relating to the pursuit of diagnosing PD within LD populations. It has been argued a diagnosis of PD is essentially adding another pejorative label to an already marginalised group. However, research indicates that a better understanding of an individual’s presentations will yield a more robust formulation and an individualised intervention plan. This will in turn, improve treatment outcomes and has the potential to benefit the quality of life for people with PD/LD.Originality/value:As stated above, there is a paucity of research in this area. Currently there are no LD specific PD psychometric assessments and adaptations to mainstream assessments causes the assessment itself to lose validity and reliability. There is a clear need for further research in this area and for the development of more LD specific tools within forensic psychology.

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Lessons from the front line: working with offenders with learning disability and personality disorder in a high secure therapeutic community

Cited by 3 publications

References 17 publications

Associations between ward climate and patient characteristics in a secure forensic mental health service

Associations between ward climate and patient characteristics in a secure forensic mental health service

Therapeutic communities for people with intellectual disability and complex needs

Assessing personality disorder in learning disabled forensic populations: A rapid evidence assessment

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