Exploratory trial of schema-focussed therapy in a forensic personality disordered population

Abstract

The management of needs and risks in personality disordered offender populations has become a focus for health and criminal justice services in the UK. Recent studies demonstrate the effectiveness of schema focussed therapy (SFT) for patients with borderline personality disorder. This study was an exploratory trial of the feasibility of implementing SFT in a population of patients with personality disorder in a high secure hospital in England. Preliminary evaluations of the effects of SFT were conducted to investigate whether those receiving SFT demonstrated significant improvements on measures of anger, impulsiveness, schemata and interpersonal style. No significant effects were evident although there was a significant increase in defectiveness/shame schema in the SFT group. Lack of effectiveness of SFT is likely due to the preliminary nature of this study. Future trials of SFT need to ensure comprehensive therapist preparation, control of TAU, bigger samples, address attrition and provide more intensive therapy.

Keywords:

• Forensic
• schema therapy
• risk
• psychological therapy
• randomised control trial

Acknowledgements

Thank you to all the patients at Ashworth Hospital who agreed to participate. Our thanks go to the research assistants who worked on this project. These include Amy Povey, Kathryn Cooper, Ros Campbell, Kaj Gohill, Charlotte Morris, Cathy Backhouse and Jade Weston. The ongoing help and support from the Ministry of Justice was greatly appreciated and special thanks for the help and support we received from the treatment team and staff at Ashworth Hospital and other sites. Thanks to the members of the study Project Board who provided sound guidance and advice throughout the study.

Funding

This work was supported by the Ministry of Justice (Research series 5/10).

Disclosure statement

No potential conflict of interest was reported by the authors.