Developing competency-based programmes in a high secure setting

Abstract

This paper describes and analyses our experiences as lecturer practitioners working in the personality disorder service at Rampton High Secure Hospital. This service is an NHS Beacon site and hosts one of the pilot projects that are part of the Home Office and Department of Health initiative concerned with the assessment and treatment of people deemed to be dangerous because of the severity of their personality disorder. The paper focuses on the development of a competency-based diploma/degree programme that is integrated with service priorities and clinical care pathways. The factors that shaped the evolution of this programme are outlined, supplemented by a critical commentary on how the course team experienced and made sense of the complex dynamics of the implementation process. Also discussed is the way our experience of facilitating dialectical behaviour therapy (DBT) group work influenced and helped us understand our work with students. Being active in service delivery ensured the course content developed from and reflected the realities of clinical practice. These issues are discussed with reference to the concept of parallel processes (Hawkins & Shohet, 2000) and by comparing the clients' experience of DBT groups with the students' experience of the competency programme.