An Evaluation of an Adapted STEPPS Group Within Forensic Services

NCT ID: NCT02601391

Last Updated: 2021-01-07

Basic Information

• Recruitment Status: WITHDRAWN
• Clinical Phase: NA
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-01-06
• Study Completion Date: 2021-01-06

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.

Detailed 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.

Conditions

Personality Disorder

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

STEPPS within forensic services.

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.

Group Type: OTHER

Adapting STEPPS within forensic inpatient services.

Intervention Type: BEHAVIORAL

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

Interventions

Adapting STEPPS within forensic inpatient services.

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

Intervention Type: BEHAVIORAL

Other Intervention Names

STEPPS-HI

Eligibility Criteria

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.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Sussex Partnership NHS Foundation Trust

OTHER

Sponsor Role: lead

Responsible Party

Liz Collins

Trainee Forensic Psychologist

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Elizabeth R Collins

Role: PRINCIPAL_INVESTIGATOR

Sussex Partnership NHS Foundation Trust

Locations

Elizabeth Collins

Hellingly, East Sussex, United Kingdom

Countries

United Kingdom

References

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.

Reference Type: BACKGROUND

PMID: 23364121 (View on PubMed)

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

Reference Type: 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.

Reference Type: BACKGROUND

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

Reference Type: BACKGROUND

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

Reference Type: 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.

Reference Type: BACKGROUND

PMID: 18414278 (View on PubMed)

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.

Reference Type: 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.

Reference Type: 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.

Reference Type: BACKGROUND

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

Reference Type: 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.

Reference Type: BACKGROUND

PMID: 3942284 (View on PubMed)

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.

Reference Type: BACKGROUND

PMID: 12839102 (View on PubMed)

Other Identifiers

SPFT-1

Identifier Type: -

Identifier Source: org_study_id