“…All therapies involve weekly individual sessions with a therapist, and also mostly involve weekly group therapy sessions. Therapies last between 12 and 24 months and patients generally undertake several different therapies before being ready for discharge (Evershed, 2010), so that the overall length of stay in the service is usually at least five years and can be considerably longer where patients have difficulty in engaging. These patients have, therefore, had extensive and often varied treatment histories, and their views are likely to be based on a considerable degree of expertise by experience.…”
Although there are now a number of psychological therapies for personality disorder, there has been relatively little research into the processes by which these therapies work. One way to explore this is to seek patients' views on the process of change. This study explores the process of change among male forensic inpatients with primary diagnoses of personality disorder. Twelve patients in a high secure personality disorder service completed a semi-structured interview about their experiences of personal change. Thematic analysis of participants' responses indicated that participants observed change in a variety of domains: core beliefs, awareness and behaviour. Consistent with previous psychotherapy research, interactions with therapists were seen as very important, but so was the wider interpersonal environment, while specific therapeutic techniques were cited relatively rarely. These results suggest that more attention should be paid to the effects of the wider interpersonal environment on therapeutic change processes with this population.
“…All therapies involve weekly individual sessions with a therapist, and also mostly involve weekly group therapy sessions. Therapies last between 12 and 24 months and patients generally undertake several different therapies before being ready for discharge (Evershed, 2010), so that the overall length of stay in the service is usually at least five years and can be considerably longer where patients have difficulty in engaging. These patients have, therefore, had extensive and often varied treatment histories, and their views are likely to be based on a considerable degree of expertise by experience.…”
Although there are now a number of psychological therapies for personality disorder, there has been relatively little research into the processes by which these therapies work. One way to explore this is to seek patients' views on the process of change. This study explores the process of change among male forensic inpatients with primary diagnoses of personality disorder. Twelve patients in a high secure personality disorder service completed a semi-structured interview about their experiences of personal change. Thematic analysis of participants' responses indicated that participants observed change in a variety of domains: core beliefs, awareness and behaviour. Consistent with previous psychotherapy research, interactions with therapists were seen as very important, but so was the wider interpersonal environment, while specific therapeutic techniques were cited relatively rarely. These results suggest that more attention should be paid to the effects of the wider interpersonal environment on therapeutic change processes with this population.
“…Indeed, given the histories of chronic trauma, abuse, neglect, and relationship difficulties that many of these patients have (Craissati, Webb, & Keen, ; Roberts, Yang, Zhang, & Coid, ), such a timescale appears quite short. It could be argued that the model of change simply reflects the goals of each stage of therapy, as outlined by Evershed () and Livesley (). However, while the development of therapeutic relationships is a specific goal of stage 1 of the treatment process, these results suggest that this process continues throughout treatment.…”
Section: Discussionmentioning
confidence: 99%
“…Treatment within the personality disorder unit is primarily psychological. Patients progress through a four‐stage treatment process (Evershed, ) based on the model of treatment for personality disorder treatment described by Livesley (). Stage 1 involves assessment and the establishment of therapeutic relationships and support.…”
Purpose. This study explores the processes of change during treatment among male forensic inpatients with primary diagnoses of personality disorder.Method. Fifty patients in a high secure personality disorder treatment service completed a checklist about how they had changed during treatment and the factors that had caused that change.Results. The results support a limited reparenting attachment-based model of therapeutic change. Self-reported levels of change were highly correlated with measures of patient functioning, though significant levels of change did not occur until the later stages of treatment.Conclusions. The behaviour of therapists was particularly important throughout treatment, though participants in the final stage of therapy reported that the behaviour of other staff was as important as that of therapists, suggesting that, by this stage of treatment they are able to extend their range of supportive and therapeutic relationships.
“…It is also well to realise that for some people under some conditions, particular stages can be very short indeed, although, for most, progress is gradual, and often there are reverses and relapses. Evershed () provided good examples of managing treatment heterogeneity using a stepped‐care treatment approach for offenders with personality disorder in high security, the model being – flexible enough to encourage change to start, to notice it when it begins, to reinforce and support it when it occurs and to intervene when it does not (p. 70).…”
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