‘The Boy Who Cried Wolf’
One cannot work in isolation with highly complex, traumatised patients with dangerous and severe psychopathologies. For those that are deemed an immediate risk to self and others, they are often psychologically isolated by illness and physically segregated from society. The high secure hospital is a collective therapist and care provider; the therapeutic relationship is multidisciplinary and a shared responsibility. Together, we adapt according to the risks we face. A collaborative, cross-disciplinary, dialectical behaviour therapy (DBT) and art psychotherapy approach to long-term segregation (LTS) in the National High Secure Learning Disability Service is one example.