Metacognitive interpersonal group therapy for adolescents with avoidant personality disorder: The case of Sofia

Abstract

Introduction: Early intervention studies for adolescents and early adults are required to explore the acceptability and effectiveness of psychological therapies across the full range of personality disorders (PDs) beyond just borderline PD. The main aim of the current paper was to describe a Metacognitive Interpersonal Therapy group adaptation for adolescents (MIT-GA) presenting with PDs featuring overcontrol and social inhibition, and in particular Avoidant PD characteristics. Methods: We report findings from a single case of a female adolescent diagnosed with Avoidant PD providing preliminary data on feasibility and the possible effectiveness of MIT-GA. Results: Evidence of acceptability and meaningful clinical gains are described.Conclusions: Results suggest that MIT-GA could be a powerful treatment option in patients with generalized social avoidance who do not currently receive goldstandard psychotherapeutic treatments. This intervention also appears to be effective and cost-effective in initiating significant clinical changes in profiles of young patients with non-borderline PD symptoms.

Structured group psychotherapies: Advantages, challenges, and possibilities

“…Yet addressing AvPD is particularly important among youth, given developmental pressures to expand their identity and social role functioning. Metacognitive interpersonal therapy has been fashioned into a time‐limited group treatment for adolescents with AvPD (Inchausti et al, 2022). In this approach, young people work on developing their goal‐directedness and social functioning through thinking together in terms of mental states.…”

Beyond treatment modalities: Clinical decisions and relational dynamics that facilitate change in group treatments

“…As described by the authors, Sandra was thus able to use the group treatment to adopt a more "curious attitude" toward herself and others. 1.4 | Metacognitive Interpersonal Group Therapy: The case of Sofia Inchausti et al (2022) described the Metacognitive Interpersonal Group Therapy adaptation for adolescents (MIT-GA) and examined its effectiveness for teens with an avoidant personality disorder. MIT-GA begins with at least one individual session to build rapport with the group leaders and develop an individualized case formulation.…”

“…Second, once a group treatment is identified, there remains the question of how and if complementary individual sessions are helpful/needed. Patients in four of the six described group treatments in this issue also participated in individual therapy sessions in addition to their group sessions (Cheli et al, 2022; Inchausti et al, 2022; Juul et al, 2022; Straarup et al, 2022). The individual sessions were typically conducted at the beginning of treatment to develop a case formulation, with a couple of additional sessions to supplement the group or help with termination (Inchausti et al, 2022; Straarup et al, 2022).…”

“…Patients in four of the six described group treatments in this issue also participated in individual therapy sessions in addition to their group sessions (Cheli et al, 2022; Inchausti et al, 2022; Juul et al, 2022; Straarup et al, 2022). The individual sessions were typically conducted at the beginning of treatment to develop a case formulation, with a couple of additional sessions to supplement the group or help with termination (Inchausti et al, 2022; Straarup et al, 2022). In one case, several months of individual sessions were conducted before the start of the group (Cheli et al, 2022) or individual sessions were interspersed with group sessions every other week (Juul et al, 2022).…”

“…Inchausti et al (2022) described the Metacognitive Interpersonal Group Therapy adaptation for adolescents (MIT‐GA) and examined its effectiveness for teens with an avoidant personality disorder. MIT‐GA begins with at least one individual session to build rapport with the group leaders and develop an individualized case formulation.…”