An Evaluation of an Adapted STEPPS Group Within Forensic Services (STEPPS-HI)

Sussex Partnership NHS Foundation Trust

Status: Withdrawn

Conditions: Personality Disorder

Treatments: Behavioral: Adapting STEPPS within forensic inpatient services.

Study type: Interventional

Funder types: Other

Identifiers

NCT02601391

SPFT-1

Details and patient eligibility

About

The purpose of this study is to determine how effective the STEPPS-HI group is at improving emotional regulation skills in those with identified difficulties in this area within forensic inpatient services. In addition, to explore whether there is increased acceptability of the adapted STEPPS group (STEPPS-HI) for this client group.

Full description

Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a manualised group programme for people primarily with a diagnosis of Borderline Personality Disorder (BPD). Although, STEPPS groups have been run within prisons in USA, it has been less formally evaluated within forensic psychiatric settings except for Pipon-Young & Cole (2012). Taking the learning from these studies into account, significant adaptations to the current STEPPS manual are needed to increase the acceptability and applicability of the group within forensic settings.

Following the adaption of the STEPPS manual for a forensic inpatient population (STEPPS HI), this research aims to investigate how effective the group is at improving emotional regulation skills in those with identified difficulties in the area as well as whether there is increased acceptability of the adapted group for the participants. The outcome of the research is intended to provide feedback on the adaption of the STEPPS manual and also an evaluation of the revised programme.

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 18 years or older.
• To give informed consent to participate in the study.
• Currently a resident in a low or medium secure unit.
• Has been diagnosed as meeting DSM-IV criteria for a personality disorder at some stage in their mental health history.
• Has identified difficulties with emotional regulation.
• Be willing and have suitable abilities to participate in a group.
• To be assessed by the clinical team as sufficiently psychologically robust to participate in the group and the research.

Exclusion criteria

• Psychiatric/psychological or any other difficulties that would mean that participants could not give informed consent.
• Intellectual/cognitive impairment which prohibits participants ability to consent or fully comprehend the study or study materials.
• Non-English speakers as there is no provision for interpreters.
• Unable to manage a group environment due to risk to self and others including bullying and violence (this will be assessed by the clinical and STEPPS-HI facilitation team.
• No evidence of emotional regulation difficulties.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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0 participants in 1 patient group

STEPPS within forensic services.

Other group

Description:

Forensic inpatients attend the STEPPS-HI group. Consent will be obtained. Pre and post group psychometric questionnaires will be completed as well as each service user attending a short semi-structured interview following the conclusion of the group . Primary nurse will fill in pre and post group questionnaires. Facilitators will complete short feedback forms each session and attend a focus group upon completion. Psychology Assistants/Interns will collect records of self harm and violence/aggressive incidents for each service user as well as records of nursing observation level and leave status taken.

Treatment:

Behavioral: Adapting STEPPS within forensic inpatient services.