Trauma-focused interventions in a high-secure Offender Personality Disorder service

This chapter explores the approach and ethos of the treatment offered in a high-secure Offender Personality Disorder Pathway Service. It has a specific focus on the role and impact of identity change, as well as the importance of considering the means of treatment delivery and a description of trauma therapy from a service user perspective. The way treatment is delivered to this population is a key component to success. Often individuals have additional needs due to adverse or limited experiences in education or due to neurodiversity and can find group settings distressing and challenging. Ensuring that material is communicated in an accessible way is key in creating safety to access past trauma. The process of identity development and the impact of traumatic experiences on this are discussed, before exploring how identity can change through the therapeutic process. The chapter describes how this has informed an intervention within the service. The process is illustrated by the narrative of a former resident who completed trauma-focused therapy within this service, including what helped them address their trauma and how this impacted on risk reduction and identity change.