Patients with personality disorders (PDs) other than borderline, with prominent features of social inhibition and over-regulation of emotions, are in need of specialized treatments. Individuals present with poor metacognition, that is the capacity to understand mental states and use psychological knowledge for the sake of purposeful problem solving; and are guided by maladaptive interpersonal schemas. We developed a short-term group intervention, Metacognitive Interpersonal Therapy in Groups (MIT-G), incorporating psychoeducational and experiential elements, to help these individuals become more aware of their drives when interacting with others; and to help them adopt more flexible behaviors via improvements in metacognition. We present results of an effectiveness study, evaluating whether we could replicate the initial positive results of our first pilot randomized controlled trial. Seventeen young adults outpatients with personality disorders were included in the 16 session program. Effect sizes were calculated for change from baseline to treatment end for the primary outcome, symptoms and functioning (Clinical Outcomes in Routine Evaluation Outcome Measure) and then for one putative mechanism of change – metacognition. Emotional dysregulation and alexithymia were also assessed. Qualitative evaluations of the acceptability and subjective impact of the treatment were also performed. MIT-G was acceptable to participants. There were medium to large magnitude changes from pre- to post- treatment on wellbeing, emotion dysregulation, alexithymia and metacognition. These gains were maintained at follow-up. There was evidence of clinically significant change on key variables. MIT-G appears acceptable to patients, as evidenced by the absence of drop-out from treatment. In light of the positive outcomes of this study and the expanding evidence base, MIT-G is a candidate for dissemination and investigations in larger trials as a possible effective intervention for PDs characterized by tendencies to overcontrol.

Young adults presenting with personality disorders (PDs) featuring overcontrol and social inhibition urgently require effective psychological interventions to help them navigate important life transitions. metacognitive interpersonal therapy-group (MIT-G) is a time-limited group program designed to enable individuals to find adaptive solutions to their social difficulties. A small randomized clinical trial (RCT) of MIT-G versus treatment as usual (TAU) was conducted with the primary outcomes of improvements in social and interpersonal functioning and global psychological symptoms. Secondary outcomes were specific symptoms of anxiety and depression and changes in alexithymia and emotion dysregulation. From 40 participants, 20 were randomized to 16 weekly sessions of MIT-G, plus 3 individual sessions and 20 to TAU þ waiting list. All 20 patients allocated to MIT-G completed treatments, while 2 dropped-out in the TAU arm. Patients in the MIT-G arm reported significant improvements on primary outcomes of functioning, interpersonal problems and global symptoms of medium magnitude, medium effect sizes for changes in depression and anxiety, and large magnitude changes for alexithymia. However, other than alexithymia no significant differences were observed between groups at treatment end. A Time 3 Condition interaction, indicated that MIT-G was associated with more rapid and larger magnitude improvements in functioning and alexithymia. MIT-G is a well-tolerated treatment option for young adults with overcontrolled PD. Further effectiveness studies in larger samples are underway.

Il periodo di emergenza sanitaria ha costretto gli operatori, soprattutto in un primo periodo, all'utilizzo degli strumenti della telemedicina per vicariare l'impossibilità della relazione in presenza. Tale periodo di crisi ha fornito però anche la possibilità di rivedere alcuni modelli di intervento e di verificare l'introduzione della Telemedicina all'interno dei percorsi clinici assistenziali esistenti. L'articolo si propone di affrontare l'inserimento di tale modalità innovativa nei Servizi di Salute Mentale evidenziandone le caratteristiche, le specificità, i limiti e i vantaggi al fine di aprire la possibilità a percorsi che prevedano una "ibridazione" degli interventi e che considerino la Telemedicina come un ulteriore strumento in dotazione al clinico per un miglioramento complessivo dei percorsi di cura.