Female prisoners with borderline personality disorder: some promising treatment developments.
BACKGROUND
The over-representation of female prisoners with borderline personality disorder (BPD) is an area of concern for HM Prison Service. Pilot programmes of Dialectical Behaviour Therapy (DBT) were undertaken for the first time in three British prisons for women diagnosed with BPD. Standard year-long programmes were piloted in two closed training prisons. Three short-format programmes were undertaken in a local allocation prison.


METHODS
Evaluation measures included psychometric tests, behavioural data, and interviews with participants and key personnel. Sixteen of the 30 women who embarked on the programmes completed them, though five dropouts were transferred or released, leaving a voluntary attrition rate of 33%. Fourteen completed all measures. A waiting-list control group of eight participants was also set up. Five completed all measures.


RESULTS
The vast majority of completers showed overall improvements in psychometric data often reaching statistical significance, and with notable effect sizes, while there was no significant overall change in the control group (though improvements were seen). A down-turn in overall self-harm was also seen.


CONCLUSIONS
Results are tentative at this stage because of the small sample size. However, despite the numerous challenges associated with implementation, outcomes showed real promise for delivering DBT in a prison setting, and its efficacy in reducing criminogenic risk and improving the manageability and quality of life for this highly problematic group. Lessons learned for future implementation in correctional settings are discussed.
International Centre for Research in Forensic Psychology, Department of Psychology, University of Portsmouth, Portsmouth PO1 2DY, UK. claire.nee@port.ac.uk
Claire
C
Nee
Sarah
S
Farman
D000328:Adult; D001883:Borderline Personality Disorder / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D035061:Control Groups; D003415:Crime / Q000517:prevention & control / Q000523:psychology; D005260:Female; D005555:Forensic Psychiatry / Q000379:methods* / Q000639:trends; D006801:Humans; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data; D011330:Prisons; D016730:Program Development; D015397:Program Evaluation; D011594:Psychometrics