Antisocial Personality Disorder: Treating the Untreatable?

Antisocial personality disorder (ASPD) is a complex and costly condition carrying high rates of co-morbidity and mortality for individual sufferers as well as harmful consequences for their families and society. Despite the publication of NICE guidelines for ASPD, the evidence base and provision of effective treatments, particularly in the community, for individuals with ASPD remain inadequate, and the belief amongst mental health professionals that the condition is untreatable remains widespread.

This talk summarises the relationship between ASPD and psychopathy and the evidence for conceptualising ASPD as a disorder of attachment. This developmental perspective provides the rationale for adapting mentalization-based therapy (MBT), a psychodynamic treatment based on attachment theory, for individuals with ASPD. The author describes the trials and tribulations of attempting to engage and research this ‘treatment-rejecting’ population and the national development of new community services for violent offenders with ASPD within the Criminal Justice System.

Workshop Leader
Jessica Yakeley is a Consultant Psychiatrist in Forensic Psychotherapy at the Portman Clinic and Director of Medical Education and Associate Medical Director, Tavistock and Portman NHS Foundation Trust. She is also a Fellow of the British Psychoanalytic Society. She has published widely on topics including medical education, violence, risk assessment, prison health, and antisocial personality disorder, and is Editor of the journal Psychoanalytic Psychotherapy.  She is Research Lead for the Royal College of Psychiatrists Psychotherapy Faculty, and for the British Psychoanalytic Council (BPC). She is currently leading the national development of new services for a multi-site randomised-controlled trial of mentalization-based treatment for antisocial personality disorder as part of the National Personality Disorder Offender Pathways Strategy.

Fee - £35/£25 trainees