Personality factors related to treatment discontinuation in a high secure personality disorder treatment service
| Pages | 29-36 |
| DOI | https://doi.org/10.1108/JCRPP-09-2014-0001 |
| Date | 09 March 2015 |
| Published date | 09 March 2015 |
| Author | Alice L. Bennett |
Personality factors related to treatment
discontinuation in a high secure personality
disorder treatment service
Alice L. Bennett
Alice L. Bennett is a Forensic
Psychologist in Training, based
at the Westgate Personality
Disorder Treatment Service
(HMP Frankland), Durham, UK.
Abstract
Purpose – The purpose of this paper is to explore the range of personality disorder diagnoses and levels of
psychopathy as assessed by the Psychopathy Checklist-Revised (PCL-R) associated with treatment
discontinuation in a sample of adult male prisoners.
Design/methodology/approach – Data from 92 male offenders in a high secure prison personality
disorder treatment unit was analysed. PCL-R and personality disorder diagnoses were predicted as being
related to increased treatment dropout.
Findings – Having a diagnosis of narcissistic personality disorder was related to treatment dropout, but
PCL-R total scores were not. There was a trend for a diagnosis of antisocial personality disorder being
associated with remaining in treatment.
Research limitations/implications – The current study highlights that narcissistic personality disorder
can be associated with treatment dropout, warranting further exploration as to why this is the case.
Practical implications – Managing responsivity issues for those presenting with a personality disorder
diagnosis could be effective in maximising treatment engagement from this specific offender group.
Originality/value – Although treatment dropout has been explored previously, this is the first study to
explore treatment dropout at a specialised unit designed specifically to provide treatment for this client
group.
Keywords Personality disorder, High security, Personality factors, Psychopathy,
Treatment discontinuation, Treatment dropout
Paper type Research paper
Introduction
Non-completion of treatment programmes in prison has various implications for treatment
services including the negative impact on staff, for other offenders attending treatment, service
cost effectiveness and denial of the service to others (McMurran et al., 2010). Improved completion
rates could leadto significant cost savings to forensic treatment services (Sampson et al., 2013).
This is particularly important given an economic climate focused on cost efficiency and reducing
costs. In addition, there is evidence to suggest that treatment non-completers have higher
rates of recidivism than untreated offenders (McMurran and Theodosi, 2007). Therefore, better
understanding of treatment dropout would help both service providers and service users, as
well as serve the wider public with regards to more effectively protecting the community.
There is an increased likelihood that offenders who meaningfully engage in (and subsequently
benefit from) behaviour treatment programmes present with reduced offendingrates and in turn
a reduced risk of harm to the public (McMurran and Theodosi, 2007). Understanding which
offenders are most likely to withdraw from treatment therefore becomes important. Offenders
who are more likely to encounter difficulties in the engagement and completion of treatment
DOI 10.1108/JCRPP-09-2014-0001 VOL. 1 NO. 1 2015, pp. 29-36, CEmerald Group Publishing Limited, ISSN 2056-3841
j
JOURNAL OF CRIMINOLOGICAL RESEARCH, POLICY AND PRACTICE
j
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