Search results for ‘Subject term:"personality disorders"’ Sort:
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Adapting interpersonal psychotherapy for borderline personality disorder
- Authors:
- MARKOVITZ John C., et al
- Journal article citation:
- Journal of Mental Health, 16(1), February 2007, pp.103-116.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Among the important characteristics of borderline personality disorder (BPD) are interpersonal difficulties and depressive symptoms. Interpersonal psychotherapy (IPT), one of the best tested time-limited psychotherapies for certain DSM-IV Axis I disorders, has demonstrated efficacy in improving psychosocial functioning and in treating major depressive disorder. This paper describes the rationale for testing IPT as a treatment for patients with BPD, the adaptation of standard IPT for such patients, and the commencement of an open, pilot study of initial tolerance and feasibility. The authors developed a treatment manual adapting IPT to BPD. Changes from standard IPT included: (i) conceptualization, and (ii) chronicity of the disorder, (iii) difficulties in forming and maintaining the treatment alliance, (iv) length of treatment, (v) suicide risk, (vi) termination, and (vii) choice of subjects within the BPD spectrum of diagnosis. The manual is being tested in an open, eight-month trial. Early results of the intervention are discussed. IPT may provide an alternative to existing treatments for patients with BPD who have interpersonal difficulties.
The emotionally abusive relationship: how to stop being abused and how to stop abusing
- Author:
- ENGEL Beverly
- Publisher:
- Wiley
- Publication year:
- 2003
- Pagination:
- 272p.
- Place of publication:
- Chichester
Emotional abuse is generally one of the least understood forms of abuse. This book offers step-by-step strategies to stop emotional abuse. It aims to help both victims and abusers to identify the patterns of abuse. The author shows each party what emotional abuse is, how it affects the relationship, and how to stop it. It focuses on the dynamic relationship in the hope of making it more likely that each person will grasp the tools for change and really use them. Personal stories help to illustrate the action plans. Topics covered include; emotional abuse the destroyer of relationships; patterns of abuse; not all emotionally abusive relationships are alike; patterns that begin in childhood: why we abuse and why we take it; action steps for those being abused, the abusive partner and the abusive couple; when your partner has a personality disorder; when your abusiveness stems from your personality disorder; should you stay or should you leave?; and preventing emotional abuse in the future.
The therapeutic qualities of unstructured time
- Authors:
- MALTEZOU Ilia, NICOLL Matthew, GOPFERT Michael
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 27(4), Winter 2006, pp.573-587.
- Publisher:
- Emerald
A significant proportion of time in a residential community is unstructured. However, there is limited understanding of the meaning or effect of unstructured time or how it contributes to the therapeutic process within the Democratic Therapeutic Community (DTC) approach. This paper utilises the experiences and observations of the authors, alongside those of a group of residents of the Webb House DTC in England, in exploring the therapeutic qualities of unstructured time. Three themes were identified and, linking theory to experience, this article hypothesises how unstructured time promotes learning in forming and sustaining relationships, facilitates secure attachments and its effect on the therapeutic alliance between staff and residents. The discussion follows how these themes contributed to the over-all therapeutic programme and also rendered unstructured time as a therapeutic structure in its own right.
Social interaction related to the functioning of forensic psychiatric inpatients
- Authors:
- VAN DER HORST Ruud, et al
- Journal article citation:
- Journal of Forensic Psychology Practice, 10(4), July 2010, pp.339-359.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
The major aim of the treatment of forensic psychiatric patients is to reduce risk of future violence by means of a positive change in the factors associated with the offence. This article argues that information on patients' social network patterns and the content of their relationships provide detailed information about relational behaviour that can be an important complement of information on behaviour provided by the traditional psycho-diagnostics. A study investigated social networks in 60 patients with personality disorders in a forensic psychiatric hospital in the Netherlands. The socio-therapists working on the patient units evaluated all possible dyadic relations between patients using a specifically designed questionnaire. Positive, friendly relationships, instrumental relationships (which provide something of advantage, such as goods or protection) and influential relationships (which lead to changes in behaviour or thinking) were all considered. This data was analysed to investigate how the patient’s social relations were associated with 3 domains of their risk-related psychosocial functioning: problem awareness; impulse control; and skills. All 3 domains were found to be associated with relational patterns; impulse control, and skills showing the strongest associations. More positive relations were maintained by patients with better basic requisite life, social, and coping skills. Better skilled patients were also more instrumentally used by other patients. The results demonstrated a clear association between mental health and networks of imprisoned patients.
Qualitative findings from a mixed methods evaluation of once-weekly therapeutic community day services for people with personality disorder
- Authors:
- HODGE Suzanne, et al
- Journal article citation:
- Journal of Mental Health, 19(1), February 2010, pp.43-51.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
This paper presents qualitative findings from a mixed methods study of 4 one-day-a-week therapeutic communities in the north of England for people with personality disorder. The quantitative findings from this study are presented separately. The study aimed to ascertain whether one-day-a-week therapeutic communities can be effective in addressing the problems associated with personality disorder. The qualitative component of the study comprised semi-structured interviews with 23 service users, 8 former service users, 4 service user consultants, 7 staff and 9 referrers. The qualitative findings offer some insight into the dynamics at work in one-day-a-week therapeutic communities that may account for some of the measurable improvements in members' mental health and functioning reported in the quantitative findings. In particular, the services enable individuals to address the two main problem areas that they face: relating to other people and self-harm. The findings suggest that one-day-a-week therapeutic communities can help people with personality disorders to address problems relating to others. In relation to self-harming, the one-day-a-week therapeutic communities can help the people with personality disorders in enabling a better understanding of their self-harming behaviour and to develop strategies for reducing their reliance on it.
Beauty in the eye of the beholder? How high security hosptial psychopathically-disordered patients rate their own interpersonal behaviour
- Authors:
- MILTON J., et al
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 16(3), September 2005, pp.552-565.
- Publisher:
- Taylor and Francis
As service user involvement, particularly through ‘expert patient’ schemes, increases for service development and implementation in the UK, the authors investigated the concordance between how patients with personality disorder view their interpersonal functioning and the views of staff who care for them in a high security mental health setting. They compared self and observer ratings of interpersonal functioning for 55 legally-defined psychopathic disorder patients detained in a high security psychiatric hospital using the CIRCLE, an instrument designed to assess interpersonal functioning. It was found that male patients underestimated their worst qualities, such as dominance or coerciveness, and overestimated their best qualities, such as nurturance, a finding not intuitively surprising but which confirms aspects of previous research. This result raises the questions of how such discordance should be interpreted, whether self or observer ratings should be considered more valid, and whether such findings have a bearing on both future risk assessment and the individual's eventual movement from high secure care.
Development of a multi-agency experiential training course on personality disorder
- Authors:
- RIGBY Mike, LONGFORD Joan
- Journal article citation:
- Psychiatric Bulletin, 28(9), September 2004, pp.337-341.
- Publisher:
- Royal College of Psychiatrists
The need for training in the management of personality disorder is now firmly established following publication of policy implementation guidance for the development of services for people with such disorders. The authors report on the development of a training course for people from a range of disciplines, which is group-based, psychoanalytically informed and experiential in nature. Those attending the course rated it highly. They showed marked changes in attitude towards, and greater confidence to work with, the client group, and were more willing to communicate their own difficulties openly both within and between agencies, to pass on their skills and to develop further the networks they had formed. Given a containing structure and reflective space, professionals from a number of agencies rapidly become able to use difficult theory to develop a ‘feeling language’ to communicate about clients with personality disorder. User presentations can be important to these changes. Repeating such a course over a number of years might lead to a more therapeutic culture within mental health services and associated agencies. The course format is likely to be transferable.
The 'double-bind of dependency': early relationships in men with learning disabilities in secure settings
- Authors:
- RAYNER Kelly, WOOD Harry, BEAIL Nigel
- Journal article citation:
- British Journal of Learning Disabilities, 43(3), 2015, pp.186-193.
- Publisher:
- Wiley
Although the development of secure attachments has been shown to be more problematic for people with learning disabilities, there is a shortage of research into the attachment experience of people with learning disabilities who have broken the law. The present study used thematic analysis to explore the attachment experiences of 10 men with learning disabilities in secure settings. Attention was paid to formative relationship experiences in early life, along with an exploration of current relationships, with the content and direction of interviews being guided by participants. Two superordinate themes emerged from the analysis: ‘disempowerment’ and ‘ineffective care’. Results suggest that participants experienced a ‘double-bind of dependency’ in which they felt a strong need for others, but had experienced unhelpful or harmful relationships. The clinical and practical implications for this are discussed. (Publisher abstract)
From the prison of my mind
- Author:
- BERGER Marie
- Publisher:
- Chipmunkapublishing
- Publication year:
- 2007
- Pagination:
- 411p.
- Place of publication:
- Brentwood
This is a collection of three books by the author, Marie Berger. The first 'And this is my adopted daughter' tells the story of Marie Berger's discovery that she was adopted, how she felt about it, and how she searched for and found her natural mother. The second book, 'A mind to be free', provides a moving account of the author's mental health problems, and her attempts to regain control of her life. The final book, 'A life worth living' deals with the difficulties faced by a person suffering from borderline personality disorder. It replaces the myths surrounding the illness with cold, hard facts.
Evaluation of day services run by agency partnerships and Therapeutic Community Service North
- Authors:
- BARR Wally, HODGE Suzanne, KIRKCALDY Andrew
- Publisher:
- Therapeutic Community Services North
- Publication year:
- 2008
- Pagination:
- 160p.
- Place of publication:
- Manchester
The findings from an evaluation of therapeutic community day services (TCDSs) are presented. The service was originally established and run by a range of agencies working in partnership with Therapeutic Community Services North (TCSN) for people with personality disorder. The specific day services under consideration were ‘Fifteen’ and ‘Personality in Education’ in Manchester, ‘Diverse Pathways’ in Leeds and ‘Rotunda’ in Liverpool. The evaluation assessed both the clinical efficacy of the model and its acceptability to service users, service employees and those who refer clients to the services. The core elements of the evaluation were to establish baseline measures of the functioning and service satisfaction of service users who were attending one of the four day services and to track changes in service users during the 12 month period following baseline assessment. Two main problem areas emerge from the qualitative interviews with service users: relating to others and self-harm and other risky behaviour.