Offender Personality Disorder Pathway: Evaluation of Team Consultation
| Published date | 02 September 2014 |
| Pages | 185-195 |
| Date | 02 September 2014 |
| DOI | https://doi.org/10.1108/MHRJ-12-2013-0041 |
| Author | Elaine McMullan,Jo Ramsden,Mark Lowton |
| Subject Matter | Health & social care,Mental health |
Offender Personality Disorder Pathway:
Evaluation of Team Consultation
Elaine McMullan, Jo Ramsden and Mark Lowton
Elaine McMullan is a
Psychologist in Clinical
Training, based at Clinical
Psychology Training
Programme, University
of Leeds, Leeds, UK.
Dr Jo Ramsden is a Clinical
Psychologist and Mark Lowton
is a Criminal Justice Lead, both
are based at Yorkshire and
Humber Pathway
Development Service,
Leeds, UK.
Abstract
Purpose – The purpose of this paper is to highlight the findings of a service evaluation project assessing the
impact of team consultation to criminal justice staff working with personality disordered offenders.
Design/methodology/approach – A qualitative design using content analysis of focus groups and
individual semi-structured interviews.
Findings – Criminal justice staff report increased awareness and understanding, use of a person-centred
approach, development of formulation skills and defensible practice following team consultation.
Practical implications – This paper will be of interest to practitioners whooffer and/or receive consultation
for work with offenders with personality disorder. Suggested changes to team consultation formats may be
of interest to services involved with the Offender Personality Disorder Pathway.
Originality/value – This paper contributes towards the emerging literature on the role of consultation and
formulation on workforce development for individuals with personality disorder. It also contributes to the
evaluation of the services offered by this specialist team as they support probation Trusts across Yorkshire/
Humber to support the community specification of the national Offender Personality Disorder Pathway.
Keywords Mental health, Personality disorder, Criminal justice, Case formulation, Offender pathway,
Team consultation
Paper type Research paper
Introduction
The International Statistical Classification of Diseases (ICD-10, World Health Organisation
(WHO), 1990) states that personality disorder comprises of “deeply ingrained and enduring
behaviour patterns, manifesting themselves as inflexible responses to a broad range of personal
and social situations” (WHO, 1990, p. 156). There is much controversy over the classification of
personality disorder (McVey and Murphy, 2010), however, it is generally accepted that
individuals who meet diagnostic criteria have experienced early attachment difficulties (Bowlby,
1982). Linehan (1993), for example talks about the role of invalidating environments on the
development of difficulties consistent with a diagnosis of Borderline Personality Disorder. It is
thought that these formative experiences lead to an inability to develop stable and integrated
representations of self and others (Bateman and Fonagy,2000). This can lead to difficulties with
regulating emotions, often resulting in the use of drugs, alcohol, self-injury and so forth, to cope
with the intensity of these emotional states (Linehan, 1993). The employment of such coping
strategies sees a high prevalence rate of individuals with personality disorder in the offender
population (61 per cent; Stewart, 2008).
Since the late 1990s national policy guidance has aimed to improve outcomes for service-users
with personality disorder. The National Institute for Mental Health in England (2003) published
policy guidance for the development of services specifically for people with personality disorder,
asserting that it was “no longer a diagnosis of exclusion”. The Dangerous and Severe
Personality Disorder Programme (DSPD; Home Office and Department of Health, 1999) was
DOI 10.1108/MHRJ-12-2013-0041 VOL. 19 NO. 3 2014, pp. 185-195, CEmerald Group Publishing Limited, ISSN 1361-9322
j
MENTAL HEALTH REVIEW JOURNAL
j
PAGE 185
To continue reading
Request your trial