ABSTRACT
This chapter will focus on the use of Schema Therapy (ST) with a male patient in a secure forensic mental health setting. This mode of therapy will be outlined in relation to personality and the case study presented, Dave. Dave was an inpatient residing in a low secure unit within a secure forensic mental health hospital. He had been diagnosed with a schizoaffective disorder and a personality disorder with elevated narcissistic and borderline traits. At the time of therapy, he had unescorted leave to the community each week. Dave’s index offence was that of murdering his wife when he was aged 22, a number of months after they had separated and she had begun a new relationship. He also sexually assaulted the victim during the index offence. He had since spent the last 20 years incarcerated, initially within the prison system, and more recently within the mental health system. Dave was referred for ST after his previous parole board hearing identified the requirement for him to explore his personality functioning in greater depth and the role that this played within his previous and current relationships. Dave engaged in over 50ST sessions. Progress was measured through behavioural evidence regarding change within ward behaviour and response within treatment sessions and was noted in his interactions and relationships with peers, staff, and family members, with Dave presenting as less detached and more engaged in these relationships.
