People with personality disorder who offend tend to be neglected by health services in most countries. In the UK, there has been renewed interest in the field since government initiatives in the end of the 1990s. Government proposals themselves are controversial, but there is growing recognition that it is unsafe, both for the general public and for the primary sufferer alike, if the neglect continues.
Years of experience have combined to provide a highly practical reference work covering:
·Models of understanding of personality development and disorder
·Methods of assessment and treatment and how they can be applied and modified
·Special issues - drug misuse, long-stay induced secondary disorders, issues pertinent to women only, 'intractable' patients
·A path for care - from initial assessment to the logistics of discharge
·Management issues - choosing staff, supervision and support of staff
Evidence-based and entirely comprehensive in its approach, practitioners will find Personality Disorder and Serious Offending both a practical and insightful adjunct that will assist them in their work.
People with personality disorder who offend tend to be neglected by health services in most countries. In the UK, there has been renewed interest in the field since government initiatives in the end of the 1990s. Government proposals themselves are controversial, but there is growing recognition that it is unsafe, both for the general public and for the primary sufferer alike, if the neglect continues.
Years of experience have combined to provide a highly practical reference work covering:
·Models of understanding of personality development and disorder
·Methods of assessment and treatment and how they can be applied and modified
·Special issues - drug misuse, long-stay induced secondary disorders, issues pertinent to women only, 'intractable' patients
·A path for care - from initial assessment to the logistics of discharge
·Management issues - choosing staff, supervision and support of staff
Evidence-based and entirely comprehensive in its approach, practitioners will find Personality Disorder and Serious Offending both a practical and insightful adjunct that will assist them in their work.
Part 1 Theoretical Framework
Describing personality and its abnormal deviations
Presenting characteristics of PD
Assessment of individuals with PD
Diagnostic arguments
Cost to society of untreated disorder (including cost to
patient)
Part 2 Origins and Grounds for Intervention and
Prevention
Early intervention and prevention and the extent of failure in
this group
Attachment theory
Providing stability and continuity
Chemically mediated impulsivity (including serotonin
agonists)
Other organic contributions and drug support
Attention deficit disorders and stimulants
Maladaptive learning and cognitive behavioural work
Psychosis and personality disorder
Chronic post traumatic stress disorder
Dynamic approaches including the narcissism debate
Theory of mind
Authority and peer group
The therapeutic community
The advantages of an eclectic and often multimodal
approach.
Part 3 The clinical setting
The advantages and disadvantages of a secure hospital setting
and/or compulsory detention
Woodstock Ward: The model for one defined patient group
A service for women
A service for patients with co-morbidity for alcohol
illegal drug addictions
A service for sex offenders
Learning disability
Translation of described models to other level of
security
Part 4 Separation and Facilitating Departure
Consultation, liaison and transfer to other services
Separation from the treatment centre
Liaison and planning matters
The law and individual rights
Confidentiality
Research tools
Research, including long term follow-up and early clinical
indicators
Audit
Developing for the future.
Chris Newrith MB ChB, MSc, MRCPsych, Consultant Psychiatrist in Psychotherapy, Birmingham Personality Disorder Service, Birmingham, UK Clive Meux MB BS, MRCPsych, Consultant Forensic Psychiatrist, Oxford Clinic Medium Secure Unit, Littlemore, UK Pamela J Taylor MB BS, MRCP, FRCPsych, FMedSci, Professor of Forensic Psychiatry, Wales College of Medicine, Cardiff, UK
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