McMurran Mary, Delight Steve
Institute of Mental Health, University of Nottingham, Nottingham, UK.
Delight Training Ltd., Macclesfield, UK.
Crim Behav Ment Health. 2017 Jul;27(3):254-264. doi: 10.1002/cbm.2032.
In England, the National Offender Management Service and the NHS have come together to try and improve management and treatment of offenders with personality disorder by developing a pathways approach to assist high-risk male offenders with severe personality disorder.
The aim of the study is to investigate service user and staff perceptions of change in this pathway.
Semi-structured interviews were conducted with 16 prisoners and 16 staff in one unit in a London-based personality disorder pathway. The four core questions were as follows: (1) what changes do you think have occurred?; (2) what do you think helped make these changes?; (3) how do you think this helped change?; and (4) what hindered positive change? Thematic analysis was applied to the narratives.
Prisoners and staff separately reported similar changes, each observing that prisoners became less anti-authority, improved their self-understanding, developed feelings of self-worth and increased their optimism about change. There was similar consensus on what they thought had brought about change - primarily development of trusting relationships. These allowed a psychological perspective on understanding prisoners' behaviour. Maintenance of this approach was seen as demanding, with barriers including 'security restrictions' curtailing purposeful activities, visits and community contact and 'stigmatising beliefs about personality disorder' in the wider prison.
Findings suggest that shared goals and progress are achievable. Difficulties in sustaining these will require a range of solutions, but wider support from the prison is essential to containing hostility to such prisoners and specialised work and ensuring the provision of purposeful activity. Copyright © 2017 John Wiley & Sons, Ltd.
在英格兰，国家罪犯管理服务局和国民保健服务体系携手合作，试图通过制定一种路径方法来改善对患有人格障碍罪犯的管理和治疗，以协助患有严重人格障碍的高危男性罪犯。
本研究旨在调查服务使用者和工作人员对该路径变化的看法。
对伦敦一家人格障碍治疗路径机构中一个单元的16名囚犯和16名工作人员进行了半结构化访谈。四个核心问题如下：（1）你认为发生了哪些变化？；（2）你认为是什么促成了这些变化？；（3）你认为这是如何促成变化的？；（4）什么阻碍了积极的变化？对访谈叙述进行了主题分析。
囚犯和工作人员分别报告了类似的变化，他们都观察到囚犯变得不那么反抗权威，增进了自我理解，产生了自我价值感，并对改变更加乐观。对于促成变化的因素，他们也有类似的共识——主要是信任关系的建立。这使得能够从心理学角度理解囚犯的行为。维持这种方法被认为具有挑战性，障碍包括“安全限制”限制了有目的的活动、探访和社区联系，以及监狱中对人格障碍“带有污名化的观念”。
研究结果表明共同的目标和进步是可以实现的。维持这些成果所面临的困难需要一系列解决方案，但监狱提供更广泛的支持对于抑制对这类囚犯的敌意和专门工作、确保提供有目的的活动至关重要。版权所有© 2017约翰·威利父子有限公司。
