Predictors and reasons for treatment non-completion at the Fens (V1)
Research type
Research Study
Full title
A mixed methods approach to investigate the predictors and reasons for treatment non-completion among a personality disordered offender sample.
IRAS ID
342884
Contact name
Ellie Archdeacon
Contact email
Sponsor organisation
University of Nottingham
Duration of Study in the UK
0 years, 3 months, 0 days
Research summary
The purpose of the application is to seek permission for a research project which aims to investigate potential predictors and reasons for treatment non-completion among a sample of high-risk male offenders with personality disorder located in a high-secure prison serving custodial sentences. The project will be a mixed methods approach comprising of one retrospective quantitative research study using existing data from clinical records in the service and one qualitative study interviewing prisoners for their experiences and motivations for treatment drop-out which will be written into two discrete research papers. The quantitative study will be based on pre-collected data on both offender characteristics (psychopathy scores and personality traits) and service characteristics (number of therapist changes and number of group cancellations) and will therefore not require new data collection. The proposed study will be the first to investigate specific personality disorder traits as predictors of treatment completion or non-completion as well as number of individual therapist changes and group therapy cancellations based on recommendations from previous literature. The qualitative study will involve semi-structured interviews with 7-12 prisoners asking for their motivations and reasons for treatment non-completion and for some, reasons for subsequent re-engagement. The proposed study will add to the small but emerging literature around treatment disengagement among personality disordered male offenders. This study will add to the current literature by being the first of its kind to investigate prisoner’s reasons and motivations for re-engagement in treatment. The research will be two short-term projects to fulfil a doctorate degree for an educational qualification and aims to be completed by the end of October 2024. The researcher (student) was currently employed by CPFT the Fens Service (where the research will take place) and is currently working on an honorary contract as a Trainee Forensic Psychologist part of the clinical team.
Lay summary of study results:
The purpose of the paper was to explore prisoner characteristics and service factors associated with treatment non-completion among a sample of high-risk male prisoners previously engaged in a five-year psychological intervention within the Offender Personality Disorder (OPD) pathway. The study investigated whether personality disorder traits and psychopathy level were predictive of treatment non-completion, as well as quantitative measures of therapeutic alliance, number of therapy group cancellations and individual therapist changes.Design/Methodology/Approach
Data from 119 male prisoners in a high-secure prison personality disorder treatment service were analysed using a series of univariate binary logistic regression analyses. Psychopathy scores and presence of traits of personality disorder diagnoses were predicted to be associated with treatment non-completion. Due to limited prior research, no directional predictions were made relating to service factors.
Findings
Binary logistic regression analyses highlighted that neither the service factors nor prisoner characteristics were predictive of treatment non-completion. These results add to a mixed evidence base regarding the relationship between personality disorder and treatment non-completion, suggesting that challenges in personality should not be assumed to relate to non-completion. As such, it may be less about personality pathology itself and more about the difficulties faced in treatment which could be exacerbated by personality pathology. The findings further emphasise a greater need for future research to adopt qualitative methodologies to learn about prisoners’ experiences of treatment and their reasons for non-completion.
Originality
The current study is one of few that investigates treatment non-completion among a high-risk prison sample. The study assessed the presence of traits of personality disorder diagnoses as potential predictors of psychological treatment non-completion and was first to quantitatively study the association between therapeutic alliance and treatment non-completion.
REC name
London - South East Research Ethics Committee
REC reference
24/LO/0407
Date of REC Opinion
23 Jul 2024
REC opinion
Further Information Favourable Opinion