Outpatient psychodynamic group psychotherapy – outcomes related to personality disorder, severity, age and gender

Kvarstein, Elfrida Hartveit; Nordviste, Ola; Dragland, Lone; Wilberg, Theresa

doi:10.1002/pmh.1352

Cited by 26 publications

(24 citation statements)

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“…Firstly, the qualitative interviews of female drop‐out patients with BPD (Hummelen et al ., ) indicated a distressing experience of strong negative emotions in a psychodynamic group setting. Secondly, a more recent quantitative study including patients with BPD in stand‐alone, outpatient psychodynamic group therapy, associated early drop‐out with enhanced symptom distress and troubling experience of the group climate (Kvarstein et al ., ). Thirdly, an RCT, which compared long‐term effects of a group‐based step‐down treatment programme (as PDT) to individual therapy, suggested that the group‐based treatment was challenging for patients with more severe psychopathology.…”

Section: Discussionmentioning

confidence: 97%

“…High comorbidity of symptom disorders may also indicate more severe personality pathology (Zanarini, Frankenburg, Hennen, et al., ; Zimmerman et al ., ).Patients with BPD can be extensive users of health services (Bode, Vogel, Walker, & Kroger, ; Frankenburg & Zanarini, ). However, health service reports also include poor compliance, treatment drop‐out, and repeated experiences of treatment failures (Barnicot, Katsakou, Marougka, & Priebe, ; Kvarstein & Karterud, ; Kvarstein, Karterud, & Pedersen, ; Kvarstein, Nordviste, Dragland, & Wilberg, ). Such treatment irregularity is likely to be linked to core BPD pathology (Hummelen, Wilberg, & Karterud, ).…”

Section: Introductionmentioning

confidence: 99%

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Mentalization‐based treatment or psychodynamic treatment programmes for patients with borderline personality disorder – the impact of clinical severity

et al. 2018

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Objectives. Mentalization-based treatment (MBT), originally designed for patients with borderline personality disorder (BPD), may be particularly indicated for severe conditions. However, there is limited documentation of how increasing severity of personality disorder (PD) effect outcomes of highly specialized treatments. This study aimed to investigate associations between clinical severity and outcomes for patients in MBT as compared to a psychodynamic group-based treatment programme (PDT).Design. A naturalistic, longitudinal, comparison study.Methods. The sample included 345 patients with BPD (PDT n = 281, MBT n = 64). The number of diagnosed PDs, PD criteria, and symptom disorders were chosen as baseline indicators of clinical severity. Clinical outcomes (global functioning, symptom distress, interpersonal problems) were repeatedly assessed over three years. Therapists' fidelity to MBT was satisfactory. Linear mixed models were the applied statistics.Results. In PDT, greater clinical severity was associated with poorer improvement rates. Clinical severity was not associated with significant differences in outcomes for patients in MBT. Differences in outcomes for patients in MBT and PDT increased significantly with higher severity of disorder.Conclusions. Supporting previous research, this study indicates that clinical benefits associated with MBT also apply for BPD patients with severe conditions. The results also suggest that increasing severity was a challenge in PDT. Practitioner pointsMBT may be particularly beneficial for severely disordered BPD patients Differences between MBT and PDT were less pronounced in moderately disordered BPD patients.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Mentalization‐based treatment or psychodynamic treatment programmes for patients with borderline personality disorder – the impact of clinical severity

et al. 2018

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“…Therapist alliance, engagement and confidence within the group setting are basic elements in a group therapy process. Monitoring therapy experience is a central issue in PD treatment . Poor treatment adherence is an often described central challenge of Borderline PD …”

Section: Discussionmentioning

confidence: 99%

“…In this first study, our aim was to construct an instrument measuring specific effects of art therapy on patients with a PD cluster B/C. We focused on patients with PD cluster B and/or C, because these PD clusters are the most prevalent and common group‐based treatment programmes for PD often recruit poorly functioning patients covering a range of personality pathology . A large part of the art therapists work with this target group, and despite the consensus on this, there is little evidence about the added value.…”

Section: Study 1: Scale Development and Confirmationmentioning

confidence: 99%

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Measuring the contribution of art therapy in multidisciplinary treatment of personality disorders: The construction of the Self‐expression and Emotion Regulation in Art Therapy Scale (SERATS)

Haeyen

Hooren

Veld

et al. 2017

Personality & Mental Health

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Despite the use of art therapy in clinical practice, its appreciation and reported beneficial results, no instruments are available to measure specific effects of art therapy among patients with personality disorders cluster B/C in multidisciplinary treatment. In the present study, we described the development and psychometric evaluation of the Self‐expression and Emotion Regulation in Art Therapy Scale (SERATS). Structural validity (exploratory and confirmatory factor analysis), reliability, construct validity and sensitivity to change were examined using two independent databases (n = 335; n = 34) of patients diagnosed with personality disorders cluster B/C. This resulted in a nine‐item effect scale with a single factor with a high internal reliability and high test–retest reliability; it demonstrated discriminant validity and sensitivity to change. In conclusion, the SERATS is brief and content‐valid and offers objective and reliable information on self‐expression and emotion regulation in art therapy among patients with personality disorders cluster B/C. Although more research on construct validity is needed, the SERATS is a promising tool to be applied as an effect scale and as a monitoring tool during art therapy treatment. © 2017 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd

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Group dynamics and therapy outcome of multimodal pain therapies: A prospective observational trial

Mihatsch,

Luchting,

Baumann

et al. 2024

European Journal of Pain

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BackgroundFor the treatment of chronic pain, interdisciplinary treatment programs are recommended. Despite continuous adaptation and optimization of this cost‐ and time‐intensive and comprehensive form of therapy, it is not successful in some patients. As personality disorders have an important influence on social interaction and behaviour, the aim of our study was to identify the possible impact of patients with personality disorders on group dynamics and to analyse the influence of group dynamics on individual therapy outcomes.MethodsWe conducted a prospective observational study in patients with chronic pain (N = 104) who participated in a 5‐week interdisciplinary treatment program. The main outcome parameters were psychological state and pain intensity before and after the program.ResultsIn contrast to our clinical assumption, we found that neither the type nor the number of patients with personality accentuation or personality disorders had a clinically relevant influence on group dynamics and that even a negative group dynamic did not negatively influence the individual therapy outcome.DiscussionThis trial analysed the connection between group dynamics and therapy outcome of multimodal pain therapies in chronic pain patients considering the factor of personality disorders. Our data demonstrated that neither the type nor the number of patients with personality disorders had a clinically relevant influence on group dynamics and that even a negative group dynamic did not negatively influence the individual therapy outcome. Hence, clinicians should not be afraid to include patients with personality disorders in their treatment programs.Significance StatementThe study emphasizes that clinicians may include patients with personality disorders in multimodal pain treatment programs and groups, provided that the maintenance of a close therapeutic bond with the patient and within the interdisciplinary team is given.

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Outpatient psychodynamic group psychotherapy – outcomes related to personality disorder, severity, age and gender

Abstract: Psychodynamic group psychotherapy is a recommendable treatment for moderate PDs, which may address avoidant strategies, but may not meet clinical challenges of borderline PD. The outcome differences related to gender and age are noteworthy. Copyright © 2016 John Wiley & Sons, Ltd.

Cited by 26 publications

References 47 publications

Mentalization‐based treatment or psychodynamic treatment programmes for patients with borderline personality disorder – the impact of clinical severity

Mentalization‐based treatment or psychodynamic treatment programmes for patients with borderline personality disorder – the impact of clinical severity

Measuring the contribution of art therapy in multidisciplinary treatment of personality disorders: The construction of the Self‐expression and Emotion Regulation in Art Therapy Scale (SERATS)

Group dynamics and therapy outcome of multimodal pain therapies: A prospective observational trial

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