Barriers to and facilitators of treatment engagement for clients with personality disorder: A Delphi survey
Tetley, Amanda C.
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Clients with personality disorder (PD) can encounter difficulties engaging in psychosocial therapy. One way to address this is to identify the factors that contribute to their low engagement. The Multifactor Offender Readiness Model (MORM), a model developed to explain poor treatment engagement in offenders, might guide the identification of engagement difficulties in clients with PD. In this study, we sought to validate and extend the MORM for clients with PD by identifying the perceived barriers to and facilitators of their engagement. A two-round Delphi Survey was employed to identify clients' and clinicians' levels of agreement on the factors that impair and promote engagement. Seventy-six clients and 55 clinicians were recruited from English specialist forensic and non-forensic personality disorder services. Our findings reveal that the perceived barriers to engagement for those with PD are in the most part congruent with the impediments outlined in the MORM. However, we do find some additional barriers relevant specifically to people with PD. A Treatment Readiness Model for Personality Disorder (TReMoPeD), which is an augmented version of the MORM, is presented. This model provides guidance for ways of taking action to improve a client's chance of engaging with services. (PsycINFO Database Record (c) 2016 APA, all rights reserved)