An Evaluation of an Adapted STEPPS Group Within Forensic Services

NCT02601391 | Withdrawn

• 1 other identifier: SPFT-1
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Personality Disorder

Keywords

STEPPS-HI; personality disorder; evaluation; forensic

Outcome Measures

Primary Outcomes (2)

• To assess change from baseline (start of group) on the Symptom Checklist-Revised (SCL-90-R), reassessing at end of group (26 weeks later).

  To assess change from baseline (start of group) on the Symptom Checklist-Revised (SCL-90-R), reassessing at end of group (26 weeks later).

  Assess at baseline (start of group) and reassess end of group (26 weeks later)

• To assess change from baseline (start of group) on the Zanarini Rating Scale for Borderline Personality Disorder, reassessing at end of group (26 weeks later).

  To assess change from baseline (start of group) on the Zanarini Rating Scale

  Assess at baseline (start of group) and reassess end of group (26 weeks later)

Secondary Outcomes (2)

• Modified Overt Aggression Scale (MOAS: Yudofsky, J. M. Silver, W. Jackson, J. Endicott, & D. W. Williams, 1986).

  Assess at baseline (start of group) and reassess end of group (26 weeks later)

• Circumplex of Interpersonal Relationships in Closed Living Environments (CIRCLE; Blackburn & Renwick, 1996).

  Assess at baseline (start of group) and reassess end of group (26 weeks later)

Other Outcomes (6)

• Number of self-harm incidents as assessed by Sussex Partnership NHS Foundation Trust Incident Reporting System.

  A record of self-harm incidents will be collected weekly from one month prior to the group starting, weekly through the group intervention (26 weeks) and then weekly for one month after the group has finished (at 30 weeks).

• Number of violent incidents as assessed by Sussex Partnership NHS Foundation Trust Incident Reporting System.

  A record of violent incidents will be collected weekly from one month prior to the group starting, weekly through the group intervention (26 weeks) and then weekly for one month after the group has finished (at 30 weeks).

• Assessing research participants (service users) views regarding group content, via attendance at a semi-structured interview utilising thematic analysis to analyse the data gathered (Braun & Clarke, 2006).

  This will be completed at the end of the group intervention (26 weeks) with service users being invited to attend a semi-structured interview.

Study Arms (1)

STEPPS within forensic services.

OTHER

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.

Behavioral: Adapting STEPPS within forensic inpatient services.

Interventions

Adapting STEPPS within forensic inpatient services. BEHAVIORAL

This study will focus upon delivering the STEPPs-HI group within Forensic Healthcare Inpatient Services.

Also known as: STEPPS-HI

STEPPS within forensic services.

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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.

You may not qualify if:

• 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.

Sponsors & Collaborators

• Sussex Partnership NHS Foundation Trust: lead

Study Sites (1)

Elizabeth Collins

Hellingly, East Sussex, BN20 4ER, United Kingdom

Location

Related Publications (12)

• Black DW, Blum N, McCormick B, Allen J. Systems Training for Emotional Predictability and Problem Solving (STEPPS) group treatment for offenders with borderline personality disorder. J Nerv Ment Dis. 2013 Feb;201(2):124-9. doi: 10.1097/NMD.0b013e31827f6435.

  PMID: 23364121 BACKGROUND

• Blackburn, R., & Renwick, S. J. (1996). Rating scales for measuring the interpersonal circle in forensic psychiatric patients. Psychological Assessment, 8, 76-84

  BACKGROUND

• Blum, N., Bartels N., St. John, D., Pfohl, B. (2002). STEPPS: Systems Training for Emotional Predictability and Problem Solving: Group Treatment for Borderline Personality Disorder. Coralville, Iowa, Blum's Books.

  BACKGROUND

• Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77 - 101.

  BACKGROUND

• Connell, J. & Barkham, M. (2007). Core-10 User Manual, Version 1.1. Core System Trust & Core Information Management Systems Ltd.

  BACKGROUND

• Dickinson T, Wright KM. Stress and burnout in forensic mental health nursing: a literature review. Br J Nurs. 2008 Jan 24-Feb 13;17(2):82-7. doi: 10.12968/bjon.2008.17.2.28133.

  PMID: 18414278 BACKGROUND

• Gratz, K. L. & Roemer, E. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26, 41-54.

  BACKGROUND

• Harvey R, Black DW, Blum N (2010) STEPPS (Systems Training for Emotional Predictability and Problem Solving) in the United Kingdom: A preliminary report. Journal of Contemporary Psychotherapy. 40, 225-232.

  BACKGROUND

• Pipon-Young, L., & Cole, S. (2012). A preliminary evaluation of the Systems Training for Emotional Predictability and Problem Solving (STEPPS) group in a women's forensic medium secure unit. Clinical Psychology Forum, 239, 35 - 39.

  BACKGROUND

• Sarkar, J., & di Lustro, M. (2011). Evolution of secure services for women in England. Advances in Psychiatric Treatment, 17, 323-331.

  BACKGROUND

• Yudofsky SC, Silver JM, Jackson W, Endicott J, Williams D. The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry. 1986 Jan;143(1):35-9. doi: 10.1176/ajp.143.1.35.

  PMID: 3942284 BACKGROUND

• Zanarini MC, Vujanovic AA, Parachini EA, Boulanger JL, Frankenburg FR, Hennen J. Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD): a continuous measure of DSM-IV borderline psychopathology. J Pers Disord. 2003 Jun;17(3):233-42. doi: 10.1521/pedi.17.3.233.22147.

  PMID: 12839102 BACKGROUND

MeSH Terms

Conditions

Personality Disorders

Condition Hierarchy (Ancestors)

Mental Disorders

Study Officials

• Elizabeth R Collins

  Sussex Partnership NHS Foundation Trust

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Trainee Forensic Psychologist

Study Record Dates

• First Submitted: October 26, 2015
• First Posted: November 10, 2015
• Study Start: January 6, 2021
• Primary Completion: January 6, 2021
• Study Completion: January 6, 2021
• Last Updated: January 7, 2021

Record last verified: 2021-01

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)