Therapeutic relationship is key to recovery from personality disorder

19 May 2014 09:00:00.000


Patients in Rampton Hospital, a secure psychiatric unit in Nottinghamshire, have reported that the single most important factor affecting their recovery was the support and commitment of their therapist.

A new study by researchers Phil Willmot and Professor Mary McMurran at the Institute of Mental Health, a joint venture between The University of Nottingham and Nottinghamshire Healthcare, explored the changes during treatment of male inpatients diagnosed with severe personality disorders.

The research is published in the journal Legal and Criminal Psychology and will be a valuable contribution to wider ongoing enhancements to the treatment of long-term detained psychiatric patients with a personality disorder. The study is unique in that it was carried out in the form of detailed interviews and questionnaires filled in by the patients themselves. It shows how the behaviour of therapists is vitally important throughout treatment and by the final stage of therapy patients begin to value interactions with other staff as also important.

Click here for full story

Forging attachments

Fifty patients, all with a diagnosis of personality disorder and convicted of serious violent or sexual offences, were asked about what they thought were the most important factors that had helped them to change in hospital.

Patients in the early stages of treatment rated the influence of their therapist as the most important factor. For patients in the later stages of treatment, relationships with nursing staff and the content of therapy became more important, but the relationship with the therapist remained important throughout the treatment process.

Phil Willmot, PhD student and consultant psychologist in the Men’s Personality Disorder Service at Rampton Hospital, said: “Many therapies for personality disorder are designed to provide what children need if they are to grow up emotionally healthy; things like feeling safe, understood and cared for. Many of our patients have suffered severe abuse or neglect in childhood and so missed out on these experiences. These results are important because our patients are confirming the vital nature of these experiences to the process of recovery from severe mental health problems.”

Crucial role of therapist

Dr John Wallace, Clinical Director at Rampton Hospital, added: “This important study adds to the evidence base concerning the crucial role of the therapist-patient relationship in the therapeutic process. While this is apparent to therapists working with patients with personality disorder, the evidence in this report is provided by patients with the severest forms of personality disorder and with extremely complex needs.”

This research provides valuable evidence about the process by which people with personality disorder can be helped in their recovery. Future work in this area aims to further explore the process of change and improve the effectiveness of treatments for severe personality disorders.

The study ‘An attachment-based model of therapeutic change processes in the treatment of personality disorder among male forensic inpatients’ by Phil Willmot and Mary McMurran is published on Monday 19 May 2014 in The British Psychological Society’s journal Legal and Criminal Psychology.

— Ends —

Our academics can now be interviewed for broadcast via our new Globelynx fixed camera facility at the University. For further information please contact a member of the Communications team on +44 (0)115 951 5798, email or see the Globelynx website for how to register for this service.

For up to the minute media alerts follow us on Twitter

Notes to editors: The University of Nottinghamhas 43,000 students and is ‘the nearest Britain has to a truly global university, with campuses in China and Malaysia modelled on a headquarters that is among the most attractive in Britain’ (Times Good University Guide 2014). It is also the most popular university among graduate employers, the world’s greenest university, and winner of the Times Higher Education Award for ‘Outstanding Contribution to Sustainable Development’. It is ranked in the World's Top 75 universities by the QS World University Rankings.

Impact: The Nottingham Campaign, its biggest-ever fundraising campaign, is delivering the University’s vision to change lives, tackle global issues and shape the future. More news…

Story credits

More information is available from Philip Willmot on +44 (0)7891 081 472;or Emma Rayner/Emma Thorne, in the Communications Office at The University of Nottingham, on +44 (0)115 951 5793,

Additional resources

No additional resources for this article

Related articles

Nottingham nurses scoop top awards

Published Date
Friday 9th May 2014

New centre sets out the future for mental health care

Published Date
Thursday 5th December 2013

New centre to pioneer research into dementia

Published Date
Friday 16th May 2014

Transforming mental healthcare through digital technology

Published Date
Tuesday 22nd October 2013

Protecting young people from self-harming and suicide

Published Date
Wednesday 22nd January 2014

Media Relations - External Relations

The University of Nottingham
YANG Fujia Building
Jubilee Campus
Wollaton Road
Nottingham, NG8 1BB

telephone: +44 (0) 115 951 5798