Metacognitive interpersonal therapy in group: a feasibility study

Abstract

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.

Acceptability and feasibility of peer-administered group interpersonal therapy for depression for people living with HIV/AIDS—a pilot study in Northwest Ethiopia

“…Generally, the group IPT was found to be feasible for use in larger HIV populations which is in agreement with reports of previous studies in LMICs [13,[37][38][39]44]. However, it is important to note that several barriers could affect its implementation.…”

Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review

“…Since up to 90% of children with ED meet criteria for a categorized disorder (441), a number of treatments are available for treating the primary disorder. Most therapies also help in improving ED (91,100,164,210,258,430,432,(445)(446)(447)(448)(450)(451)(452)(453)(454)(455)(456)(457). Only the Light Therapeutic Procedure (447), and the Emotion Regulation Training (ERT) for adolescents with BPD (455) showed no improvement (for details, see Tables 1, 2).…”

Building the alliance and using experiential techniques in the early phases of psychotherapy for avoidant personality disorder

“…In a second study, all three patients with AvPD treated in a multiple-baseline case-series no longer met criteria for a diagnosis of AVPD after 1 year of treatment (Gordon-King | 1221 et al, 2021), moderate to large effect size changes in primary outcomes on AvPD-specific personality functioning were found as well as improvement in alexithymic symptoms. Furthermore, for patients with mixed PDs including AvPD, there are also outcomes from two noncontrolled studies and one pilot randomized controlled trial of MIT delivered in a semi-structured psychoeducational/experiential program (MIT-Group) (Inchausti et al, 2020;Popolo et al, 2018Popolo et al, , 2019. Summarizing across these treatment studies, patients with PDs (including AvPD diagnoses or prominent AvPD traits) demonstrated robust adherence to therapy and therapeutic improvements in terms of symptoms, social functioning, and metacognition.…”

“…Furthermore, for patients with mixed PDs including AvPD, there are also outcomes from two noncontrolled studies and one pilot randomized controlled trial of MIT delivered in a semi‐structured psychoeducational/experiential program (MIT‐Group) (Inchausti et al, 2020; Popolo et al, 2018, 2019). Summarizing across these treatment studies, patients with PDs (including AvPD diagnoses or prominent AvPD traits) demonstrated robust adherence to therapy and therapeutic improvements in terms of symptoms, social functioning, and metacognition.…”