Assessing attachment in the context of the biopsychosocial model

It will be clear by now that there is no way of understanding the development of personality disorder without TAKING A HISTORY. Understandably, this may not be possible at the first meeting, but should be a priority during the first few weeks of contact with the individual offender. The primary purpose of a personal, family and social history is to understand the developmental pathway, resulting in the emergence of problematic relationships and behaviours in adulthood. This approach is not at odds with a primary duty to protect the public, as understanding the relationship between personality disorder and offending is a crucial element in developing an effective risk management plan. However, there are additional benefits to history taking, most important being the positive effect of striving to work with the individual in arriving at a greater understanding of the person; this greatly improves the chances of engaging in a collaborative relationship.

OASys clearly contains within it all the relevant categories for an assessment – with sections on childhood problems, relationship difficulties, experiences of education, employment and criminogenic attitudes. However, understanding the development of attachment is dependent on a rather explorative (or ‘curious’) approach which requires qualitative information to develop a meaningful story of development which has explanatory value. This is not always easy, as personality disordered individuals may struggle to access their own thoughts, feelings and reflections on their life. The Assessing Attachment Tips below highlight some of the key issues.

The reality is that some interviews proceed fairly smoothly, while others are more challenging. With experience, interviewers can develop their own ways of gaining quality information from reluctant or emotionally inarticulate individual offenders.

Assessing Attachment – Tips

• Individuals with dismissive or detached attachment styles tend to idealise or minimise early difficulties; individuals with anxious avoidant/ambivalent attachment styles tend to be overwhelmed by their early adverse experiences with strong emotional responses in interview. Both styles indicate poor reflective functioning (capacity to think clearly).
• Do not accept the first response, but be prepared to probe a little for more qualitative information.
• Do not impose your own view of abuse and its consequences; you are interested in the individual’s personal experience as it was at the time, and how they might view it now with the benefit of hindsight.
• Thoughts and feelings are probably more important than the ‘facts’.
• Don’t forget resilience and buffers. Look for good attachments (grandparents or teachers?), positive traits (intelligence or prowess at sport), appropriate anxieties about behaviour.
• Identify specific relationship difficulties and how they might differ in different situations – perhaps in dating relationships as compared to wider social relationships.