Making Your Emotions Work for You: A pilot brief intervention for alexithymia with personality‐disordered offenders

Abstract

One strategy for reducing premature termination of therapy is to offer pre‐therapy preparation. Here, we describe an intervention targeting alexithymia in offenders with personality disorders. ‘Making Your Emotions Work for You’ is a one‐day group intervention consisting of four evidence‐based components: Psychoeducation, Recognizing Emotions, Self‐Awareness and Seeking Information. Pre‐intervention and post‐intervention scores on measures of alexithymia (Toronto Alexithymia Scale‐20 (TAS‐20)) and psychological mindedness (Balanced Index of Psychological Mindedness (BIPM)) are presented for five male personality‐disordered offenders. This small sample showed consistent scores in the dysfunctional direction on both psychometric measures, indicating that there does appear to be a need to address alexithymia in this group. Overall, participants reported positive experiences with the intervention. No reliable pre‐intervention to post‐intervention changes were observed on TAS‐20 scores. On the BIPM Interest scale, reliable improvement was observed for three participants and reliable deterioration for one participant. On the BIPM Insight scale, one participant reliably improved, and one reliably deteriorated. While alexithymia may not be changed by this intervention, participants may become more interested in exploring their emotions, which may enhance engagement in therapy. Copyright © 2011 John Wiley & Sons, Ltd.

Barriers to and facilitators of treatment engagement for clients with personality disorder: a Delphi survey

“…A range of techniques are available that could be adopted to address some of the client‐specific barriers to treatment readiness identified in the TReMoPeD. These include cognitive‐behavioural approaches to modify low self‐efficacy beliefs and negative treatment appraisals (Sheldon & Tennant, ); psychoeducation to increase the client's self‐knowledge and enhance understanding of treatment relevance (Banerjee, Duggan, Huband, & Watson, ); mindfulness training to reduce negative affect and impulsivity (Howells, Tennant, Day, & Elmers, ); training to improve the client's ability to identify and discuss their emotions (McMurran & Jinks, ); interventions to address poor social problem solving skills (Huband, McMurran, Evans, & Duggan, ); motivational interviewing to help the client reach a decision to engage (Miller & Rollnick, ); and goal‐based interventions to help the client see the benefits of therapy in terms of wider life goal attainments (McMurran, Cox, Coupe Whitham, & Hedges, ). Therapists are aware of the importance of developing the therapeutic alliance, and supervision can focus on how their behaviour and therapeutic technique impact on the development of this alliance (Ackerman & Hilsenroth, ).…”

The Emotion Mapping Activity: Preliminary evaluation of a mindfulness‐informed exercise to improve emotion labeling in alexithymic persons

“…First, the video used to orient participants in the EMA condition to the EMA exercise included approximately 45 seconds of psychoeducational information on emotion labeling. Previous research suggests that psychoeducational interventions may have beneficial effects on alexithymia (Byrne, Bogue, Egan & Lonergan, ; McMurran & Jinks, ). Without further research, it therefore remains unclear whether observed effects were driven by the psychoeducational elements of the orientation video, the EMA exercise, or a combination.…”

“Who needs secure services for personality disorder?” Results of an expert Delphi study with professional staff

“…The universality of offenders’ motivation as a driver of efficacy highlights the importance of focussing on it throughout their custodial sentence. Interventions that target engagement, commitment and PD symptomatology, such as the ‘goals-based approach’ [40] have shown promise and are already utilised in some clinical settings. Similar models could be employed across an offender’s journey from sentencing to community re-settlement.…”

“…Additionally, the process of aggregation in the Delphi study is open to arbitrary judgement [40] with studies defining consensus in a variety of ways. While this degree of subjectivity allows for freedom within a research project, it does impact on what is reported.…”