1st Edition

Personality Disorder and Serious Offending Hospital treatment models

    398 Pages 4 B/W Illustrations
    by CRC Press

    People with personality disorder who offend tend to be neglected by health services in most countries. In the UK, there has been renewed interest in the field since government initiatives in the end of the 1990s. Government proposals themselves are controversial, but there is growing recognition that it is unsafe, both for the general public and for the primary sufferer alike, if the neglect continues.

    Years of experience have combined to provide a highly practical reference work covering:

    ·Models of understanding of personality development and disorder

    ·Methods of assessment and treatment and how they can be applied and modified

    ·Special issues - drug misuse, long-stay induced secondary disorders, issues pertinent to women only, 'intractable' patients

    ·A path for care - from initial assessment to the logistics of discharge

    ·Management issues - choosing staff, supervision and support of staff

    Evidence-based and entirely comprehensive in its approach, practitioners will find Personality Disorder and Serious Offending both a practical and insightful adjunct that will assist them in their work.

    Part 1 Theoretical Framework
          Describing personality and its abnormal deviations
          Presenting characteristics of PD
          Assessment of individuals with PD
          Diagnostic arguments
    Cost to society of untreated disorder (including cost to patient)
    Part 2 Origins and Grounds for Intervention and Prevention
    Early intervention and prevention and the extent of failure in this group
    Attachment theory
    Providing stability and continuity
    Chemically mediated impulsivity (including serotonin agonists)
    Other organic contributions and drug support
    Attention deficit disorders and stimulants
    Maladaptive learning and cognitive behavioural work
    Psychosis and personality disorder
    Chronic post traumatic stress disorder
    Dynamic approaches including the narcissism debate
    Theory of mind
    Authority and peer group
    The therapeutic community
    The advantages of an eclectic and often multimodal approach.
    Part 3 The clinical setting
    The advantages and disadvantages of a secure hospital setting and/or compulsory detention
    Woodstock Ward: The model for one defined patient group
    A service for women
    A service for patients with co-morbidity for alcohol
    illegal drug addictions
    A service for sex offenders
    Learning disability
    Translation of described models to other level of security
    Part 4 Separation and Facilitating Departure
    Consultation, liaison and transfer to other services
    Separation from the treatment centre
    Liaison and planning matters
    The law and individual rights
    Research tools
    Research, including long term follow-up and early clinical indicators
    Developing for the future.


    Chris Newrith MB ChB, MSc, MRCPsych, Consultant Psychiatrist in Psychotherapy, Birmingham Personality Disorder Service, Birmingham, UK

    Clive Meux MB BS, MRCPsych, Consultant Forensic Psychiatrist, Oxford Clinic Medium Secure Unit, Littlemore, UK

    Pamela J Taylor MB BS, MRCP, FRCPsych, FMedSci, Professor of Forensic Psychiatry, Wales College of Medicine, Cardiff, UK