Motivating factors for male forensic patients with personality disorder

Treatability is currently a crucial component for detention under the Mental Health Act (England and Wales) for the Psychopathic Disorder (personality disorder) classification and there is continuing debate about the nature and assessment of treatability of individuals with personality disorder. Previous research has identified motivation to engage in treatment as a significant factor in the assessment of treatability; however, motivation is not a static predictor but a state of readiness or eagerness to change, which may fluctuate from one time or situation to another. While previous studies have explored factors within the individual that are used to assess treatability, this study aims to explore what, if any, aspects of an inpatient forensic setting influence patients' motivation to engage in treatment.

The study examines patients' experiences of engaging in treatment in an inpatient forensic Personality Disorder Directorate using a qualitative approach to identify possible service-, ward- and therapist-level influences on patients' motivation to engage.

Preliminary categories were identified across the data, including: support, treatment, safety, external belief, belonging, internal motivation and therapeutic relationship.

Implications for the service are identified and areas for further qualitative exploration are highlighted.