Women and Personality Disorder: WKUF+ Lou Morgan Executive Director BIGSPD 2015

Our Ethos Emergence is a service user-led organisation with the overarching aim of supporting all people affected by personality disorder including service users, carers, family & friends and professionals

Why Women's KUF? Women in prison who experience issues related to personality disorder are more likely to: End up being recalled to prison Accumulate adjudications Drop out or not make progress in accredited programmes Make complaints against staff Self-harm Be transferred to NHS settings Trigger intense emotional reactions in staff

Why Women's KUF? Why gender matters – some statistics: 40% of under 17-year old women in YOIs have previously been looked after by local authorities. 50% of women in prison have experienced domestic violence 65% of women in prison have substance use problems 83% of women in prison have a longstanding illness (compared to 32% of the general female population) Women are twice as likely as men to have experienced some form of mental illness in the year preceding admission to custody Around 66% of women in prison have dependent children under 18, 40% of those are children under 10 years Source: Fossey, M & Black, G Under the Radar: Women with Borderline Personality Disorder in Prison (2010 )

Why Women's KUF? Because gender matters… McNeish & Scott (2014) Women & Girls at Risk: Evidence across the life course Social inequalities Abuse and Violence Gender Expectations

Stepped Training WKUF – Single day basic introductory awareness for all staff within female estate WKUF+ – 4 Day training programme for staff working closely with women in prison settings. Women and Personality Disorder Bsc Module – Available as a stand alone module. Women and Personality Disorder Msc module – Available as a stand alone module, and as part of Msc (cohorts 5 & 6)

Development of WKUF+ Based on findings from consultation with staff and women in prison. Developed by Dr. Julia Blazdell (Emergence Project Manager) and Anna Motz (Consultant Clinical and Forensic Psychologist, Oxford Health). Delivery co-facilitated by an individual with lived experience of personality disorder and professional with a forensic background. Piloted 4 cohorts in Midlands Region (Drake Hall)

Learning Aims Enable staff to understand and respond effectively to expressions of distress. Develop a psychologically informed approach to working with women. Explore psychological processes of developing personality disorder Create safe learning space for staff to reflect on their own response to women they work with Develop case formulation skills

Overview of the Training Day 1:Understanding How Women Present Day 2: Understanding Trauma and Managing Distress Day 3: Boundaries, Containment and Relational Security Day 4: Learning into Practice Use only helvetica font Use only this colour orange either normal or bold or black normal or bold

Topic Areas Functions of behaviours Rules for living/schemas Trauma, and its impact on relationships Repetition of destructive patterns within prison environments e.g. violence, self harm. Boundaries, containment, splitting Relational security Case formulation Putting learning into practice

Pilot Evaluation 100% agree or strongly agree: the course content is relevant and appropriate Learnt a lot from the training The course confirmed experience with client group Trainers created a good learning environment Trainers had strong understanding of topic Sessions well organised 90% participants - training will improve the way I do my job.

Feedback A very positive and interactive training experience: highly recommended! The training has kept me focussed on seeing the individual It was good, thoroughly enjoyed it and I can use the skills everyday working with women in [the] service To be able to assist women in crisis. To be less judgemental Really worthwhile training Understanding the prisoners’ backgrounds and experiences will help me to understand what triggers their behaviour and help me develop more empathy and explore different ways of working with prisoners. I believe every member of staff would benefit from participating in this course.

Next steps? Would this material be useful elsewhere? If so, where? How can we best support staff to continue putting learning and reflection into practice?