Learning the subtle dance: The experience of therapists who deliver mentalisation‐based therapy for borderline personality disorder

Gardner, Kathryn Jane; Wright, Karen; Elliott, Alison M; Lamph, Gary; Graham, Simon; Parker, Lucy; Fonagy, Peter

doi:10.1002/jclp.23208

Cited by 1 publication

(1 citation statement)

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“… 24 A recent study of therapist experiences of Mentalization-Based Therapy for borderline personality disorder found therapists valued the uncertainties exposed by this approach leading to growth for both themselves and their patients. 25 In summary, structured approaches were found to be valued for their guidance, but lacked in discussing complexities or conceptualization, while unstructured approaches seemed to allow for more opportunities for therapeutic connection, growth, and meaning making.…”

Section: Introductionmentioning

confidence: 99%

Promoting Meaning and Recovery for Psychosis: Comparison of Metacognitively-Oriented Psychotherapists and Clinicians in Psychiatric Rehabilitation

Faith,

Wiesepape,

Kukla

et al. 2023

NDT

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Introduction Recovery from psychosis is an expected and desired outcome in psychiatric rehabilitation that may involve subjective outcomes related to personal recovery. While a considerable amount of qualitative research has examined patients’ experience of recovery oriented approaches, there are less studies examining clinicians’ perspectives. Examining the clinician point of view is important for both supporting clinicians within recovery-oriented practice, as well as for understanding underlying therapeutic processes. The aims of this study were to explore clinician experience of offering different psychiatric rehabilitation treatments for individuals with psychosis, and to understand similarities and differences of clinicians whose work differed in its recovery emphasis. Methods Open-ended interviews were conducted with 10 psychotherapists providing Metacognitive Reflection and Insight Therapy (MERIT), a recovery oriented form of integrative psychotherapy focused on subjective aspects of recovery, and 10 clinicians providing standard psychiatric rehabilitation services. Results Thematic analysis revealed important similarities and differences between these two groups of providers. There were seven themes found for MERIT therapists: Comfort with uncertainty, Emphasis on collaboration, Being part of therapeutic change, Connecting with clients, Emphasis on patient autonomy, Experiencing growth, and Therapist use of self-awareness. There were four themes found for psychiatric rehabilitation clinicians: Value of a structured approach, Focus on a strengths-based approach, Witnessing behavioral change, and Building rapport to support the work. Discussion As expected, both similarities and differences arose between clinician groups. Results indicated that both groups focused on the therapeutic relationship and monitoring progress and outcomes. Unexpectedly, MERIT therapists reported growth as well as comfort with uncertainty. These findings suggest that MERIT is a a psychotherapy that offers unique opportunities for creative and flexible exploration of meaning and agency that is both challenging and rewarding for clinicians. Implications for supporting healthy clinician practice and the development of services are discussed.

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Section: Introductionmentioning

confidence: 99%