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This paper provides a clinical practice overview of the challenges that can arise when working with dangerous and severe personality‐disordered patients in a high secure hospital. Poor engagement and treatment readiness, mistrust, paranoia and dominant interpersonal styles are all clinical features that affect treatment delivery. The paper discusses the impact of these features, and suggests how clinicians can engage effectively with individuals who have personality disorders in regard to therapy in general.
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© Emerald Group Publishing Limited
2011
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