Recovery approaches with women with a diagnosis of personality disorder in secure care

A literature review in Section A reviews the conceptual and empirical literature with regard to the usefulness and challenges inherent in applying recovery approaches in secure services, with a particular focus on women with a diagnosis of personality disorder.
Section B. Background: Some studies have suggested that recovery approaches could be facilitated in secure mental health services despite a number of inherent tensions. However, none have explored if this applies to women with a diagnosis of personality disorder in secure care. A group whose needs have historically been overlooked, and can present with complex care-seeking behaviours.
Aims. To explore how staff working with these women understand and apply recovery approaches in secure units.
Method. Eleven multidisciplinary staff members working in a medium-secure unit in the UK participated in in-depth interviews. The data was analysed using grounded theory.
Results. A preliminary model was generated, which comprised of five categories: secure base, balancing tensions, therapeutic relationship, initiating recovery, and nurturing recovery.
These appeared to interact and influence each other throughout the recovery process.
Conclusions. Staff are required to continually balance a number of tensions and as such they need a secure base from which to explore the service-users’ unique recovery process through the medium of collaborative therapeutic relationships. Staff sharing a recovery ethos that is embedded in the culture of a conducive environment, and is supported by supervision and teamwork, fosters the actualisation of recovery principles of empowerment, identity formation, and hope.
Section C provides a critical appraisal of the study as well as a personal reflection on what was learnt through the process of the conducting the study.