Edinburgh Napier University

  Background: Occupational participation is important for personality disordered offenders (PDOs) because
it is integral to health and desistance from offending. What influences occupational participation is
unknown for PDOs in the community, limiting effective intervention to affect change. In England and
Wales, the Offender Personality Disorder Pathway aims to improve outcomes for people considered
highly likely to have a severe personality disorder and who present a high risk of reoffending, who are
determined to be PDOs on the basis of a structured assessment. This study identified the influencers of
occupational participation for the population who receive this service.
Method: In this critical realist, qualitative study, narrative interviews were conducted with 18 PDOs
supervised by probation in England. Transcripts were analyzed using a grounded theory approach to
establish influencers of occupational participation.
Results: Four themes describe influencers of occupational participation: function of occupations;
influence of the past; external forces; and learning and adaptation. The latter theme reflected
understandings of occupational adaptation described by the Model of Human Occupation.
Conclusions: An intervention to increase prosocial occupational participation should be developed and
evaluated for PDOs in the community, taking account of occupational participation over the life course.