Engaging clients with personality disorder in treatment

This paper seeks to highlight the findings from a research project on improving treatment engagement for clients with personality difficulties.

The authors provide an overview of the studies conducted to date. These are a systematic review of the literature examining non‐completion of psychosocial treatment by people with personality disorder, a systematic review of assessments to measure treatment engagement, and a Delphi survey of both staff and patients' views on factors that impact on engagement in psychosocial treatment for this client group.

Poor engagement with psychosocial treatment is an issue for clients with personality disorder and rates of non‐completion are high. Discontinuation of treatment is associated with adverse clinical outcomes. Although a number of assessments exist for measuring engagement, none can be described as comprehensive and few are adequately validated. Engagement factors identified from the survey were broadly in keeping with previous work, but additional factors specific to this client group were identified. A treatment readiness model for people with personality difficulties is described.

Research outputs from the project are a set of specifications for good practice in facilitating engagement, and a web‐based training package aimed at helping staff improve their understanding of their clients' engagement issues.

The findings will be useful to service managers as well as clinicians working directly with people with personality difficulties. Improving client engagement will improve clinical outcomes and service cost‐efficiency.