Rep36 Understanding Personality Disorder

participants showed gains in terms of reduced
impulsiveness, increased self-esteem, higher levels
of socialisation and better custodial adjustment.
This was supported by the staff observation
checklist, which tends to show positive gains in
self-management. This indicates that cognitive
skills programmes may address some of the
needs of personality disordered offenders.
Although there is considerable evidence of
the short-term effectiveness of cognitive skills
programmes in the UK, the evidence in terms of
reduced recidivism is mixed. This has prompted
further consideration of the factors that seem to
be important in influencing longer term
effectiveness. One of the factors might be that
the later evaluations took place at a time when
the programmes underwent major expansions
and there may have been a loss of treatment
integrity as a result. For example, unsuitable
offenders may have been referred onto
programmes in order to meet completion
targets. Some authors (e.g. Ellis & Winstone,
2002) have noted that large-scale expansion may
also mitigate against a culture of responsivity
within programme delivery, which is an
important factor in the success of cognitive-
behavioural models. 
An additional factor is the need to integrate
programme work with overall offender case
management more effectively. This was
highlighted in a recent report by Clark, 
et al
.,
(2004), who conducted a qualitative study
examining the experiences of a sample of
prisoners who took part in cognitive skills
programmes. They reported that the large
majority of the sample benefited from
participating on the programme and felt it was
helpful in providing them with skills to avoid re-
offending. However, these gains were not always
reinforced once offenders had completed the
courses. Clark 
et al
., (2004) argued that this
highlighted the importance of providing support
and aftercare for offenders to help them
maintain and apply the skills they have learnt on
programmes. They also drew attention to the
social and institutional factors that enabled
offenders to make the best use of treatment
programmes and argued that they should be
delivered as a part of a holistic approach to
addressing offenders’ needs. The Home Office is
taking steps to implement lessons from this
research by giving greater emphasis to the
integration of case management with the
delivery of programmes.