City Research Online

‘It’s not just about lock and key, it’s about you as a human being': treating the person before the personality disorder in prison

Ralph, Sarah (2015). ‘It’s not just about lock and key, it’s about you as a human being': treating the person before the personality disorder in prison. (Unpublished Doctoral thesis, City University London)


There continues to be an over-representation of female offenders diagnosed with borderline personality disorder (BPD) within UK prisons (Sansone & Sansone, 2009). Dialectical Behavioural Therapy (DBT) has shown effectiveness in managing the symptomatology of BPD and has been adapted for a forensic context (Nee & Farman, 2005, Gee & Reed, 2013). There is limited qualitative data available pertaining to the experiences of clients within DBT programmes and none for a forensic context.
Seven female prisoners completed semi-structured interviews regarding their experience of completing a 16-week DBT programme.
Interpretive phenomenological analysis (IPA) illuminated six superordinate themes and 19 subordinate themes, which can be understood as features of personality and behavioural change. Superordinate themes were prison life, which highlighted an impact to life in prison through a reduction of prison disciplinary and risk procedures, and an increase in privilege levels. 'It's a struggle' represented the challenges participants faced and overcame. Increased connection to others illuminates the change in personal relationships participants experienced. Emotional awareness represents the participant's gain in understanding and managing emotions. Who am I? Depicts the increased understanding, acceptance and value participants experienced for themselves. The bigger picture represents the participant's ability to reflect upon and re-evaluate a situation, the increased awareness of another person's perspective, their increased understanding of consequences of their actions, and their future outlook on life.
Themes are discussed in relation to the potential impact the DBT programme may have for people experiencing emotional and behavioural instability within the prison environment, suggesting engagement with DBT should be based upon individual case formulation rather than BPD diagnosis. The potential of DBT in addressing the government initiative the Offender Personality Disorder (OPD) strategy and recidivism is explored. Finally, the limitations to this study, recommendations for clinical practice, and future research needs are defined.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Departments: School of Health & Psychological Sciences > Psychology
Doctoral Theses
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
[thumbnail of Ralph, Sarah Vol. 1 (Redacted).pdf]
Text - Accepted Version
Download (12MB) | Preview
[thumbnail of Ralph, Sarah Vol. 2 (Redacted).pdf]
Text - Accepted Version
Download (269kB) | Preview


Add to AnyAdd to TwitterAdd to FacebookAdd to LinkedinAdd to PinterestAdd to Email


Downloads per month over past year

View more statistics

Actions (login required)

Admin Login Admin Login