Tips for one-to-one working:
Respecting the core traits and interpersonal style:
• Expect and ignore demeaning comments and hostility. The offender is defending himself. • Do not challenge distorted core beliefs and thoughts as this will lead to a fight that you will lose. • Excessive friendliness may appear cunning and deceitful, as if the offender is being lulled into
a false sense of security.
• A major goal is to free the individual of mistrust. Take slow and progressive steps to develop trust. • Retreating behind procedures and keeping the client out of the loop may increase paranoia. • Deliberately counteract suspicion: increase transparency, share documentation. Avoid secrecy
and explicitly describe steps involved in decision-making.
• If the paranoia centres on you, consider third party mediation (your senior’s help) to lessen grievances.
• Reacting defensively may heighten their state of paranoia and confirm their view of the world as hostile. Do not co-work with two of you in the room.
• Without colluding in the distorted world vision, try and understand and empathise with the development of the belief and its emotional impact.
Tips for general offender management:
• Consider a central point of contact (e.g. a keyworker) through which other agencies can communicate, and try to cut down on multiple reporting systems.
• Persistent offers of too much contact, either in regularity or intensity, may be experienced as overwhelming. Keep modest aims in forming an alliance – a more distant approach may be beneficial. Be as flexible as possible about setting the frequency and regularity of contact.
• Behavioural controls may threaten their autonomy, heighten powerlessness and increase a sense of persecution. Use restrictions sparingly and give careful consideration to which are necessary. Try to include the individual in setting up these controls.
• Do not confuse antagonism with non-compliance. Try not to increase controls in response to a paranoid response as this may have an adverse effect. Instead, stay focussed on compliance with reasonable requests.
• Try to enhance the individual’s control over areas of personal importance.
Appendices | 135
5. Cluster ‘C’ Personality Disorders (Avoidant,
Dependent and Obsessive-Compulsive)
Profile of the Cluster C PD’s
Cluster C PD’s are sometimes referred to as the anxious and fearful disorders, due to the underlying sense of anxiety which is common to all. The pathology may be less obvious than some of the other PD’s making them easy to miss.
Avoidant PD is characterised by high levels of social anxiety, which stems from an underlying sense of defectiveness and inadequacy. Individuals with avoidant PD are typically socially withdrawn, apprehensive, shy and awkward. Due to an inner sense of inferiority, they are ever vigilant for signs of rejection and failure and avoid situations in which they fear that their perceived shortcomings will become apparent to others. They may desire close personal relationships, but are also hypersensitive to rejection. Substance misuse may be used as an escape.
Dependent PD is characterised by a negative self
concept associated with core feelings of helplessness and inadequacy and a corresponding need to be taken care of. They fear being alone and actively attach themselves to others who they feel will be able to meet their needs. They may be highly suggestible and struggle to make decisions without considerable help and reassurance. Emotionally they suffer with pervasive feelings of anxiety and behaviourally they are passive, under assertive and submissive.
Obsessive Compulsive PD is characterised by excessive self-control, a pre-occupation with order, rules, hierarchies and an unwavering conviction in their high moral, ethical and professional standards. Sufferers may be highly self-critical
with any inability to attain their high standards being viewed as a catastrophic failure. They may also expect others to meet their high standards and be highly critical of those with different ideals. They are likely to possess a rigid and ruminative thinking style, be highly perfectionist, procrastinate for lengthy periods and therefore struggle to complete tasks. May be confused with schizoid PD.
PD View of Self View of Others Main Beliefs Main Strategy
Avoidant Inadequate,
worthless Critical, demeaning “It’s terrible to be rejected, put down” “If people know the real me they’ll reject me”
Avoid Dependent Weak,
helpless Strong, overwhelming “I need people to survive, be happy” “I need to have a steady flow of support, encouragement”
Attach/Be submissive
Quick Reference
Overview: Often referred to as the anxious and fearful disorders due to the behaviours which are symptomatic of the individual disorders.
Link to Offending: Generally likely to be low risk and obsessive-compulsive traits may actually be a protective factor for risk of recidivism. However, Dependent PD may be associated with domestic violence and avoidant and dependent PD’s are some of the most commonly found PD’s in child sexual offenders.
Tips: Avoid confrontational approaches, reward compliance and work towards developing greater autonomy and
PD View of Self View of Others Main Beliefs Main Strategy
Obsessive
Compulsive Responsible, competent Irresponsible, incompetent “I know what’s best” “Details are crucial” “People should do better” Control Relationship to offending
Cluster C PD’s in general are not strongly associated with a high risk of serious offending and obsessive compulsive traits in particular confer a particularly low risk. Despite this, personality characteristics associated with cluster C PD’s may facilitate offending behaviour in a number of ways: • Dependent personality features are characteristic of an established typology of male domestic
abusers. In such individuals violence may be facilitated by a pre-occupied and anxious attachment style, a resulting fear of abandonment and a tendency to experience jealousy.
• Avoidant and Dependent PD’s are some of the most frequently identified personality disorders in child sexual offenders (and internet sexual offenders) and may be associated with difficulties establishing rewarding intimate relationships with adults, social withdrawal and loneliness.