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It is most unlikely her level of disturbance will spontaneously resolve simply as a function of incarceration, and any amelioration of her risk (as well as any humane considerations that might be considered) will only take place if she is placed in an intensive, in-patient therapeutic setting. There is, I am informed, no opportunity for such a placement at this time
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In the interim, if Debbie is to remain in Parklea, consideration of her vulnerability and developmental needs has to be taken into account. Debbie is a young woman, still developing her identity. She has a need for exercise and an opportunity to get her weight gain under control. She requires opportunities for (safe) social interaction, and clearly has a major requirement for treatment. It is not possible for adequate treatment to be given to Debbie whilst in Parklea. The kinds of treatment Debbie needs are a mix of individual and group based strategies, and no group exists in Parklea that would be suitable for her. None the less, some beginnings of appropriate therapeutic contact should occur. This might ideally take the form of treatments modelled on the work of Linehan and Beck in managing severe and destructive personality disorders, and parallelled by a continuing monitoring of her relevant medication needs. If prison personnel are to be used for this purpose, an arrangement should occur such that the prison personal (sic) receive some supervision and debriefing in their therapy with experienced practitioners from Cumberland, or whatever other appropriate therapeutic venue she may eventually be transferred to. Ideally, transfer to some therapeutic venue will be considered, and to prepare for that, treatment from that setting should begin whilst she is in Parklea. This will enable a bridge into the next phase of her management, whilst security needs are managed."