Mental and Behavioral Health

Biography

Biography: Vladislava Susanina

Abstract

The available literature on deliberate self-harm (DSH) within offender populations has largely focused on the characteristics of people who use this behaviour rather than its functions and how they are managed within treatment settings. This study explored the functions of DSH as well as the mechanisms and processes addressing this problem within a hospital-based therapeutic community (TC) for personality disordered (PD) offenders. The study conducted a secondary data analysis using information collected prior to and during the treatment process. It included a total of thirty-one participants with a history of DSH, some of which had continued to use this behaviour during their admission. A Thematic Analysis was employed in the process of interpreting the data. Overall, four main themes emerged. Those engaging in DSH appeared to be struck in an internal conflict which was an overarching theme. Patients were split between their need for and fear of relationships. DSH appeared to resolve this conflict while also being a resistance against thinking and change. The themes relating to the treatment processes were: the importance of belonging, permissiveness and challenge, and empowerment. The TC’s capacities to provide a secure and supportive environment, tolerate but challenge difficult periods, and empower patients were crucial aspects of treatment. Overall, the TC model was an effective intervention. However, not all patients improved, thus consideration needs to be given as to who is able to engage and when the best time to start treatment is.