Showing papers by "Conor Duggan published in 2005"

The manualization of a treatment programme for personality disorder

Abstract: Background The advantages of manualized psychological treatments include: the promotion of evidence-based practice, the enhancement of treatment integrity, the facilitation of staff training, and the potential replicability of treatment. Argument The manualization of a multi-component, multidisciplinary treatment programme for male personality-disordered offenders is described. The background to this development is explained and the treatment setting is described briefly, followed by a description of the eight treatment manuals: (1) the treatment overview, (2) Psychoeducation focusing on personality disorder diagnosis and core beliefs, (3) Trust and Self-awareness group exercises, (4) Stop & Think! - a social problem-solving intervention, (5) Controlling Angry Aggression, (6) Controlling Substance Use, (7) Criminal Thinking/Belief Therapy, and (8) Skills for Living - a social skills manual. Conclusions In addition to the original aims of manualization, this exercise has clarified the treatment programme, included less highly trained staff in the delivery of therapy and permitted the evaluation of treatment modules, thus contributing to the incremental evaluation of the overall programme. These manuals may usefully be shared with other practitioners in the field. Copyright © 2005 Whurr Publishers Ltd.

Temporal reliability of psychological assessments for patients in a special hospital with severe personality disorder: a preliminary note.

Abstract: Background The new programme for assessing those with dangerous and severe personality disorder relies heavily on psychological assessments of personality disorder and risk. Methods The temporal reliability of assessments of psychopathy (PCL-R), risk (HCR-20) and persoruility was assessed using the International Personality Disorder Examination (IPDE) in 15 randomly selected mak prisoners in a high secure hospital carried out at intervals varying between a mean of nine and 19 months after initial assessments by a variety of assessors. Results Using the intra-class correlation coefficient the agreement varied between 0.57 (HCR'2O), 0.58 (PCL-R) and 0.38-0.70 for IPDE personality disorders, with the best agreement for antisocial personality disorder (0.70). Comment TKese levels of agreement are consistent with other recent work on temporal reliability of personality instruments but are a little too low for confidence in these measures alone in the assessment process.

Beauty in the eye of the beholder? How high security hospital psychopathically-disordered patients rate their own interpersonal behaviour

Abstract: As service user involvement, particularly through ‘expert patient’ schemes, increases for service development and implementation in the UK, we 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. We 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. We found that male patients underestimated their worst qualities, such as dominance (p < .0005) or coerciveness (p < .0005), and overestimated their best qualities, such as nurturance (p < .0005), 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 ...

Treatment of severe personality disorder

Abstract: There is as yet no accepted definition of severe personality disorder or a clear evidence base for its treatment. However, it is accepted that most of those with severe personality disorder meet the criteria for several different categories and that antisocial personality characteristics, often associated with criminality, are prominent in the condition. The continuum of severity of personality disturbance is examined from a therapeutic perspective.

The effectiveness of a single day's training in changing attitudes and practice among professionals ‐ a pilot study

Abstract: We conducted a pilot study to investigate the impact of a single day's training, the purpose of which was to disseminate good practice, by asking delegates to complete a questionnaire, six months after attending the day. The completion rate was 56%. Our results suggested only a modest effect on practice, 54% of respondents reporting a change in at least one of the five domains of practice asked about. The question arises of whether this type of training is the most effective way of disseminating good practice.