The ultimate shock absorber
| Author | Eleanor Fellowes |
| Published date | 01 June 2018 |
| DOI | 10.1177/0264550518755310 |
| Date | 01 June 2018 |
| Subject Matter | Articles |
Article
The Journal of Community and Criminal Justice
Probation Journal
The ultimate shock
2018, Vol. 65(2) 152–169
ª The Author(s) 2018
absorber: Probation
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DOI: 10.1177/0264550518755310
officers’ experience
journals.sagepub.com/home/prb
of working with male
service users on the
Offender Personality
Disorder Pathway
Eleanor Fellowes
Portman Clinic, Tavistock and Portman NHS Foundation Trust, UK
Abstract
Since the publication of its strategy in 2012, the Offender Personality Disorder
(OPD) Pathway continues to develop across the National Probation Service and
prison estate. The relational crux of the Pathway exists between the probation
officer and service user, with the former holding the lead professional role. This
study aimed to develop an understanding of practitioners’ experience of inha-
biting this role, in order that enhanced insight into the relationship at the centre of
the Pathway could emerge. Discussion focuses on the implications of the findings
for enabling relational security and psychologically informed practice in complex
and risk averse systems.
Keywords
mental health, one-to-one case work, organizational change, organizational culture,
personality disorder, practitioners, probation, relationships, supervision
Corresponding Author:
Eleanor Fellowes, Visiting Lecturer, Portman Clinic, Tavistock and Portman NHS FT, 8 Fitzjohn’s Avenue,
NW3 5NA, London, UK.
Email: EFellowes@Tavi-Port.nhs.uk
Fellowes
153
Introduction
Since the publication of its strategy in 2012, the Offender Personality Disorder
(OPD) Pathway continues to develop across the National Probation Service and
prison estate (Joseph and Benefield, 2012). Central to its structure, from com-
missioning through to the frontline, is the integration of health with justice via
partnership and collaboration. This is embedded in the Pathway’s outcomes,
which link reducing repeat serious offending with improving psychological
health and relationships. In turn, these are linked to developing staff compe-
tence, confidence and attitudes and service quality (NOMS and Department of
Health, 2014). As such, positive outcomes for service users, services and the
public are framed as inextricable from the relationships the Pathway involves, in
keeping with the intra- and inter-personal nature of personality disorder (Millon
et al., 2004). The relational crux of the Pathway exists between the probation
officer and service user, with the former holding the lead professional role. This
article is an overview and discussion of a small, grounded theory study that
aimed to increase understanding of probation practitioners’ experience of this
relationship. Practice-near qualitative research presented as a means by which
this critical relationship could be explored, ensuring that efforts to foster psy-
chologically informed practice are informed and supported by the experiences
and perceptions of staff (Cooper, 2009).
The rationale and design underpinning this interview-led study will be provided,
followed by an outline and discussion of the key findings. At the core of the data that
emerged was the emotional complexity built into this area of practice. Practitioners
described negotiating anxious organizational cultures to try and hold relationships
with men who find such proximity extremely difficult. I hope that the discussion
started here does some justice to the demands and meaning which practitioners
described experiencing in this work.
Background to the research
The research was undertaken as a Service Development Project, the final tier of
the MSc within the Personality Disorder Knowledge and Understanding
Framework. This is an education programme that has contributed to the work-
force development activity occurring under the auspices of the OPD Pathway.
As such, this study was undertaken within an academic context that was pre-
dicated on contributing to personality disorder services. The inquiry question for
this qualitative study was: how do probation officers perceive and describe their
relationships with male service users eligible for inclusion in the OPD Pathway?
The aim was to generate a context-specific grounded theory of the professional
relationship, from the practitioners’ perspective. The hope being that through
inviting participants to articulate and reflect on their relationships with service
users, and the factors which impact on them, enhanced insight into this
underwritten aspect of practice might emerge. Grounded theory was chosen as
a methodology because it is congruent with the project’s aim of generating
154
Probation Journal 65(2)
understanding of probation practice that is rooted in participants’ perceptions of
their working contexts (Smith and Biley, 1997; Charmaz, 2014). The premise
of this study was that in-depth understanding of practitioners’ experience could
have useful implications for effective, responsive and sustainable training and
supervisory structures. Her Majesty’s Prison and Probation Service (HMPPS) (the
National Offender Management Service at the time of the project) tasks itself
with the provision of environments which are positive, safe, secure and decent;
this research was intended to contribute to enabling professional relationships
which might also be described in such terms.
Literature review
Within the grounded theory tradition, a formal literature review is explicitly not
undertaken because of the risk of imposing a preconceived theory. However,
working from the understanding that any emergent theory ‘does not and cannot
stand outside of’ the researcher’s view (Charmaz, 2014: 239), an overview of the
literature that inevitably influenced this study will be provided, before further dis-
cussion of the methods and findings.
Most significant is the application of psychodynamic theory and practice to
forensic mental health. As a theoretical and clinical approach, this body of work
prioritizes understanding the relational and emotional complexity of forensic
systems (Adshead, 2012; Yakeley, 2010; Reiss and Kirtchuk, 2009; Morgan and
Ruszczynski, 2007). At the risk of over-generalizing, this paradigm depicts staff
and service users as existing in complex relational webs, heavily influenced by
formative and ongoing experiences of trauma, abuse, neglect, discrimination and
exclusion. These dynamics are depicted as being played out within and by sys-
tems (Aiyegbusi and Clarke-Moore, 2009). Attending to this experience is pre-
sented as a core task of teams and services; failures to do so are linked to
egregious boundary breaches (Fallon et al., 1999) and iatrogenic, fraught
occupational cultures (Lowdell and Adshead, 2009). At its core, this is a position
that holds that the emotional dimension of social experience contains meaning,
and accessing this can assist in understanding how and why groups and orga-
nizations are structured and behave as they do (Menzies-Lyth, 1988 [1959];
Cooper and Lousada, 2005).
Along these lines, Kurtz (2005), Kurtz and Turner (2007), Boyle et al.
(2009) and Gordon (2011) are all examples of research studies that aim to
understand something of the practice worlds of staff in forensic and/or per-
sonality disorder settings. With different emphases, these studies illuminate
the emotional complexity of forensic practice. Relationally, staff are asked to
straddle a range of contradictions: being caring whilst detaining; knowing
about early life trauma whilst managing a ‘perpetrator’; meeting high levels of
need and deprivation whilst managing high levels of risk. In addition, the
(often malevolent) influence of wider organizational and socio-political con-
texts is also repeatedly discovered. For example, the complexity of the work is
disavowed in the policies and procedures that govern organizational life,
Fellowes
155
being more oriented towards defending against systemic anxiety. The dis-
cussions that emerge from these findings argue that forensic work is pre-
dicated on engagement with trauma and distress, and as such reflective
structures are critical in giving teams opportunity to metabolize this experi-
ence, in the service of good practice.
On a smaller scale, this research project is an attempt to explore similar terri-
tory, but within the context of probation and the OPD Pathway. It is not unchar-
tered: most recently, Phillips et al. (2016) explore how the work the National
Probation Service undertakes is experienced by its workforce. The emphasis on
stress, supervision and workload are themes that resonate with this project. Further
detail is provided by analysis of the provision of psychoanalytically-informed
clinical supervision to probation staff (Wood and Brown, 2014). Resonant with
the forensic mental health literature, emphasis is placed on the impact of wider
organizational dysfunction, in addition to the emotional labour of working
with service users who are ‘often severely traumatised’ (Wood and Brown,
2014: 330).
In the criminological field, desistance scholarship is the area that has given
most attention to the supervisory relationship at the centre of probation practice.
Indeed, one of the consequences of the findings of desistance research has
been to re-establish the working alliance as central to the discourse of probation
(NOMS, 2011), albeit with reservations about how fully this practice agenda
reflects the prominence the research gives to social and political contexts
(Farrall, 2004, McNeill, 2017). On a micro and macro level, relationships are
integral to the way the process of desistance has been...
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