Early termination of treatment in personality disorder treated in a psychotherapy hospital

Chiesa, Marco; Drahorad, Carla; Longo, Silvia

doi:10.1192/bjp.177.2.107

Cited by 70 publications

(48 citation statements)

References 19 publications

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“…Remarkably, dropout rates were low compared to other studies conducted in PD populations [65]. A second strength is the powerful statistical control of potential confounders, using the multiple propensity score methodology.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Outpatient, Day Hospital, and Inpatient Psychotherapeutic Treatment for Patients with Cluster B Personality Disorders

Bartak

Andrea²,

Spreeuwenberg

et al. 2010

Psychother Psychosom

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Background: For patients with cluster B personality disorders there is no consensus regarding the optimal treatment setting. The aim of this study was to compare the effectiveness of different psychotherapeutic settings for patients with cluster B personality disorders, i.e. outpatient, day hospital, and inpatient treatment. Methods: The study was conducted between March 2003 and June 2008 in 6 mental health care centres in the Netherlands, with a sample of 207 patients with a DSM-IV-TR axis II cluster B diagnosis. Patients were assigned to 3 different settings of psychotherapeutic treatment and effectiveness was assessed at 18 months after baseline. An intention-to-treat analysis was conducted for psychiatric symptoms (Brief Symptom Inventory), psychosocial functioning (Outcome Questionnaire-45), and quality of life (EQ-5D), using multilevel statistical modelling. As the study was non-randomised, the propensity score method was used to control for initial differences. Results: Patients in all 3 settings improved significantly in terms of psychiatric symptoms, social and interpersonal functioning, and quality of life 18 months after baseline. The inpatient group showed the largest improvements. The comparison of outpatient and inpatient treatment regarding psychiatric symptoms showed a marginally significant result (p = 0.057) in favour of inpatient treatment. Conclusions: Patients with cluster B personality disorders improved in all investigated treatment settings, with a trend towards larger improvements of psychiatric symptoms in the inpatient setting compared to the outpatient setting. Specialised inpatient treatment should be considered as a valuable treatment option for cluster B personality disorders, both in research and in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Outpatient, Day Hospital, and Inpatient Psychotherapeutic Treatment for Patients with Cluster B Personality Disorders

Bartak

Andrea²,

Spreeuwenberg

et al. 2010

Psychother Psychosom

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“…Uwidacznia się to w pracy z pacjentami z BpD -prawdopodobieństwo dropoutu wynosi 50-60% (głównie we wczesnej fazie terapii) [18]. Według badań zwiastunami przedwczesnego zakończenia terapii przez pacjentów z BpD są: młody wiek pacjenta, wysoki poziom wrogości, lęku, złości i impulsywności [19]. Gunderson [18] podkreśla znaczenie subiektywnego doświadczenia z zawieraniem relacji terapeutycznych.…”

Section: Predyktory Przedwczesnego Zakończenia Psychoterapiiunclassified

“…pacjenci rezygnujący przedwcześnie mówią na początku o braku satysfakcji z poprzedniej relacji terapeutycznej, poczuciu bycia krytykowanym przez innego terapeutę, małym wsparciu rodziny i wykazują nikłą motywację do podjęcia terapii. Znaczenie mają też: trudności w nawiązaniu satysfakcjonującego kontaktu z pracownikami ośrodka, trudności organizacyjne i w dotarciu na terapię, problemy z wejściem w społeczność terapeutyczną [19]. Kolejne czynniki to: trudności w zmianie dysfunkcyjnych mechanizmów radzenia sobie, zewnętrzne niesprzyjające okoliczności, presja rodziny.…”

Section: Predyktory Przedwczesnego Zakończenia Psychoterapiiunclassified

Therapeutic relationship in the therapy of patients with borderline personality disorder

Klatkiewicz¹

2015

Psychoter

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psYcHoterapia 2 (173) 2015 strony: 23-32 therapeutic relationship trust bPD summary: the therapeutic relationship is crucial in a long-term therapy. some authors claim that it is the most important factor of the treatment. What are its determinants? What factors decide about the fact whether it is formed or not? What is the importance of creating a relationship with a BpD patient? is forming a therapeutic relationship, based on trust, with a BpD patient a condition of the therapy or its significant phase and success? What are the difficulties and constraints in constructing therapeutic relationships with those patients? What is the experience of therapists in different aspects of the therapeutic relationship with this type of patients like? Which reactions of a psychotherapist support forming a good relationship and which ones make it difficult? the aim of this article is to search for the answers to these questions, basing on a selection of publications, contemporary research and the experience of psychotherapists. the factors related to BpD patients, simplifying forming a therapeutic relationship and hindering this process, are going to be described. Benefits possible to be achieved by a BpD patient with disturbed interpersonal relationships, who manages to build a secure therapeutic relationship are going to be also analyzed. Jednym z kluczowych czynników leczących w terapii pacjentów z zaburzeniem

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“…Specifically, clients with obsessive-compulsive disorder (Hansen, Hoogduin, Schaap, & de Haan, 1992) and personality disorder diagnoses (Chiesa, Drahorad, & Longo, 2000;Gunderson et al, 1989;Shea et al, 1990;Skodol, Buckley, & Charles, 1983) Clients with a history of legal issues such as delinquency behaviors (Pagnin, de Queiroz, & Saggese, 2005), fire setting, prostitution for drugs (Vourakis, 2005), and probation (Claus & Kindleberger, 2002) have demonstrated high attrition rates in psychotherapy. Furthermore, logistical problems interfering with appointments such as scheduling and transportation have shown to be related to premature termination (Ball et al, 2006).…”

Section: Predictors Of Premature Terminationmentioning

confidence: 99%

Impact of Clinician Expectations on Termination Status and Therapeutic Outcome

Connor¹

2014

PsycEXTRA Dataset

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Early termination of treatment in personality disorder treated in a psychotherapy hospital

Abstract: Important subjects and process variables contributing to early drop-out in people with personality disorder were identified, with potential implications for clinical practice.

Cited by 70 publications

References 19 publications

Effectiveness of Outpatient, Day Hospital, and Inpatient Psychotherapeutic Treatment for Patients with Cluster B Personality Disorders

Effectiveness of Outpatient, Day Hospital, and Inpatient Psychotherapeutic Treatment for Patients with Cluster B Personality Disorders

Therapeutic relationship in the therapy of patients with borderline personality disorder

Impact of Clinician Expectations on Termination Status and Therapeutic Outcome

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