Treating High-Risk Offenders with Personality Disorder: What Can Work When Prison Doesn’t

Individuals who have personality disorder and commit serious, violent offences present a particular challenge in terms of rehabilitation and risk management. Drawing from the experiences of those working within the Millfields Unit specialist service for high-risk male offenders with personality disorder, this book provides readers working in forensic personality disorder services, whether in hospital or in prison, with a primer on the theory underpinning a successful treatment model and demonstrates how to put it into practice.

Written by staff in dialogue with their patients, the innovative approach explored within this book brings together psychodynamic thinking and offending behaviour theory to create a more holistic way of addressing the suffering caused, both to themselves and others, by these complex individuals. Chapters explore:

• the rationale and theoretical underpinnings of the psychodynamically informed therapeutic community approach
• the process of selecting, assessing and admitting a patient
• how to form a therapeutic alliance in the face of challenging presentations
• the potentially volatile process of change
• the importance of transitions and aftercare
• staff selection and training at beginner and higher levels
• working as part of a multidisciplinary team.

An essential read for forensic mental health clinicians and allied health professionals, this book will be instrumental for those already dedicated to working with this target population. It will challenge certain stigmas by demonstrating that an informed treatment approach carries with it a good chance of successful rehabilitation and can also be highly rewarding.

Celia Taylor is Consultant Forensic Psychiatrist with West London NHS Mental Health Trust and a Fellow of the Royal College of Psychiatrists. She previously was Lead Clinician at Millfields Unit, a national medium secure service for high-risk male offenders with severe personality disorder.

Brittni Jones is Director of BE Psychology Ltd; Chartered Clinical Psychologist and Psychodynamic Psychotherapist. She is currently also Therapeutic Community Specialist, supporting the review of the accreditation of Therapeutic Communities. She was previously Lead Psychologist at Millfields Unit.