Table Of ContentWorking Positively
with Personality Disorder
in Secure Settings
A Practitioner’s Perspective
Edited by Phil Willmot and Neil Gordon
A John Wiley & Sons, Ltd., Publication
Working Positively with Personality
Disorder in Secure Settings
Wiley Series in Personality Disorders
Series Editor : Professor Eddie Kane – Personality Disorder Institute, University
of Nottingham
The Wiley- Blackwell Series in Personality and Mental Health publishes both
single - authored and multi- authored books. The aim of the series is not merely
to present critical fi ndings and commentaries based in excellent science but also
to ensure they are grounded in the realities of day -t o - day practice and service
delivery. The series seeks to draw together work from across the wide spectrum
of professional disciplines that are essential to the development of well- balanced
theoretical perspectives and truly holistic service delivery. Books in this series
will be useful to clinical practitioners, lawyers, policy makers, ethicists, services
users, carers and those who fund and manage the complex systems of health,
social care and criminal justice.
Published
Using Time, Not Doing Time: Practitioner Perspectives on Personality Disorder
and Risk
Allison Tennant and Kevin Howells
Working Positively with Personality Disorder in Secure Settings: A Practitioner’ s
Perspective
Phil Willmot and Neil Gordon
Forthcoming
Forensic Care for Personality Disordered and Psychopathic Offenders
Mark Freestone
Working Positively
with Personality Disorder
in Secure Settings
A Practitioner’s Perspective
Edited by Phil Willmot and Neil Gordon
A John Wiley & Sons, Ltd., Publication
This edition fi rst published 2011
© 2011 John Wiley & Sons Ltd.
Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s global
Scientifi c, Technical, and Medical business with Blackwell Publishing.
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apply for permission to reuse the copyright material in this book please see our website at www.
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The right of Phil Willmot and Neil Gordon to be identifi ed as the authors of the editorial material in
this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
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Library of Congress Cataloging-in-Publication Data
Working positively with personality disorder in secure settings: a practitioner’s perspective / edited
by Phil Willmot and Neil Gordon.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-470-68380-4 (cloth) – ISBN 978-0-470-68379-8 (pbk.)
1. Personality disorders–Treatment. 2. Prisoners–Mental health services. I. Willmot, Phil.
II. Gordon, Neil, 1959-
[DNLM: 1. Personality Disorders. 2. Forensic Psychiatry. 3. Hospitals, Psychiatric.
4. Mentally Ill Persons–psychology. 5. Prisoners–psychology. 6. Security Measures. WM 190]
RC554.W67 2010
616.85'820086927–dc22
2010027874
A catalogue record for this book is available from the British Library.
This book is published in the following electronic formats: eBook [9780470973127]; Wiley Online
Library [9780470973110]
Set in 10 on 12 pt Galliard by Toppan Best-set Premedia Limited
Printed & Bound in Singapore by Ho Printing Singapore Pte Ltd.
01 2011
To the patients and colleagues who inspired this book.
Contents
About the Editors and Contributors x
Series Preface xiv
Eddie Kane
Preface xvii
Foreword xix
Kath Lovell
Acknowledgements xx
Introduction 1
Phil Willmot and Neil Gordon
Section 1: Context 11
Chapter 1 From ‘Anxious and Sad’ to ‘Risky and Bad’: Changing
Patterns of Referrals to the Personality Disorder Service 13
Jenny Marshall and Phil Willmot
Chapter 2 Trapped in the ‘Special Hospital’: The Problems
Encountered in the Pathway to Medium Secure Units 22
Amanda Tetley and Gopi Krishnan
Section 2: The Treatment Process 33
Chapter 3 What Works with Forensic Patients with Personality
Disorder? Integrating the Literature on Personality
Disorder, Correctional Programmes and Psychopathy 35
Phil Willmot and Amanda Tetley
viii Contents
Chapter 4 Assessing Personality Disorder in Forensic Settings 49
Phil Willmot
Chapter 5 A Treatment Pathway for High Security Offenders with
a Personality Disorder 66
Sue Evershed
Section 3: The Therapeutic Relationship 91
Chapter 6 Attachment Theory and the Therapeutic Relationship in
the Treatment of Personality Disorder 93
Louise Sainsbury
Chapter 7 Therapeutic Style and Adapting Approaches to Therapy 115
Kerry Beckley
Chapter 8 The Grey Areas of Boundary Issues When Working with
Forensic Patients Who Have a Personality Disorder 127
Sue Evershed
Chapter 9 One Patient’s Therapeutic Journey 147
‘James’ and Louise Sainsbury
Section 4: Supporting and Developing the Therapeutic
Workforce 157
Chapter 10 Therapists’ Experiences of Therapy 159
Neil Gordon, Kerry Beckley and Graham Lowings
Chapter 11 Making Sense of Interpersonal Dynamics: A Schema
Focused App roach 172
Kerry Beckley
Chapter 12 The Importance of Systemic Workforce Development
in High Secure Settings 188
Andrea Milligan and Neil Gordon
Chapter 13 Establishing a Supervision Culture for Clinicians
Working with Personality Disordered Offenders in
a High Secure Hospital 200
Andrea Daykin and Neil Gordon
Section 5: Outcomes 211
Chapter 14 An Individual Approach to Assessing Change 213
Jason Davies
