Introduction to Difficult Behaviours

The “Managing Difficult Behaviours” guides have been developed to provide practitioners with simple practical advice to support their work.

The guide is suitable for all staff grades, and particularly those who feel they lack experience – who are working with service users who present with difficult behaviours and may have longstanding psychological difficulties. The service user may or may not have a formal diagnosis of personality disorder. Even when a diagnosis is available, it does not always help services to develop a management plan. All too often, services and individual practitioners are left to manage a variety of problematic behaviours, which are challenging and can leave them feeling incompetent or unconfident about their skills.

The managing difficult behaviours guides are focused on understanding and managing a number of common difficult behaviours that are associated with personality disorder or longstanding psychological difficulties. Each guide provides links to other information on personality disorder that can be found on this website, in particular, the top tips section of the PD Guidance.
The advice has been developed from the clinical experience of LPP practitioners, and each guide is structured in the following format:

  • Definition – what is the difficult behaviour?
  • Who and how – outlining the personality disorders more commonly associated with the difficult behaviour and providing more detail of the range of behaviours
  • Why – the difficult behaviour may occur.
  • Impact on practitioner – describing what are common emotional experiences and responses to this type of behaviour.
  • The practitioner stance – highlighting a number of do’s and don’t’s in attempting to work with the service user.
  • Managing the behaviour – tips to help identify, analyse and intervene with the problem.

Introduction to Top Tips

These “Top Tips” provide easily applied, practical guidance for working with personality disordered offenders (as defined by the DSM-V). The information here is based on up to date theoretical principles and considerable clinical experience.

The aim of Top Tips is to synthesise this wealth of knowledge and experience in order to enable practitioners to feel more competent, confident and optimistic in managing this group.

Not all the DSM-V personality disorder sub-types are covered, because we wanted to focus on those most relevant to offending and therefore most commonly encountered by those working in criminal justice services.

Tops Tips have been developed for schizoid, narcissistic, antisocial, paranoid, borderline and Cluster C disorders. Each Top tip outlines:

  • Quick reference – for each personality disorder, including an Overview, Link to offending and Tip.
  • A profile of the personality disorder – the main behavioural, cognitive and emotional characteristics. For each personality disorder a framework is provided that outlines the individual’s view of self, view of others, main beliefs and main interpersonal strategy.
  • Relationship with offending –the link between that personality disorder and frequently associated offending behaviour. This includes reasons why that person might commit a particular type of offence.
  • Diagnostic features of the personality disorder–a summary of the DSM-V diagnostic criteria.
  • Tips for working with the personality disorder –practical, easy to apply management, treatment and interpersonal strategies.