Patient Factors Predicting Dropout from Supportive-Expressive Psychotherapy for Patients with Personality Disorders

Thormählen, Barbro; Weinryb, Robert M.; Norén, Kristina; Vinnars, Bo; Bågedahl-Strindlund, Margaretha

doi:10.1093/ptr/kpg039

Cited by 57 publications

(32 citation statements)

References 26 publications

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“…No other diagnostic variables, type of problems, severity of problems, interpersonal problem variables, demographic factors, or motivation predicted early dropout. Low age being a predictor of early dropout is in line with results from some other studies concerning dropout from psychiatric research (35,37,38) and from psychotherapy (49). However, most studies concerning psychotherapy show that age is unimportant for early termination (17).…”

Section: Discussionsupporting

confidence: 84%

Helping alliance and early dropout from psychiatric out-patient care

Johansson

Eklund

2006

Soc Psychiat Epidemiol

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This is an author produced version of a paper published in Social Psychiatry Psychiatric Epidemiology. This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination. Abstract:Background: The study examined client factors of relevance for the establishment of the helping alliance and for dropout in a routine psychiatric setting, admitting a variety of diagnoses and staffed with a multi-professional team. Method: Newly-admitted patients (n= 122) and staff completed questionnaires regarding the helping alliance, and the patients also regarding motivation, symptoms and interpersonal problems. The patients were also diagnosed according to the ICD-10 and followed up concerning early dropout. Results: Several variables correlated with the helping alliance and multivariate analyses showed that the cold/distant factor, motivation and the interpersonal sensitivity factor were the most important factors in establishing the helping alliance. Moreover, it was the alliance as perceived by the patients and not the staff that proved to be the most essential variable. A logistic regression analysis showed that early dropout was predicted by low helping alliance, low age and cold/distant. Conclusion:The most important client factors for establishing the helping alliance and for predicting early dropout seem to be those relevant to interpersonal processes. Further, the therapists'/staff's responsiveness to these client factors seems to be of decisive importance.

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Section: Discussionsupporting

confidence: 84%

Helping alliance and early dropout from psychiatric out-patient care

Johansson

Eklund

2006

Soc Psychiat Epidemiol

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“…Younger patients may be less motivated for treatment and demonstrate less positive attitudes toward mental health professionals, which could contribute to premature termination [29]. Because PD generally entails long-standing, severe, and often ego-syntonic interpersonal problems, it may only be with age that patients become aware of such problems and commit themselves to find more adaptive ways of living (e.g., by remaining in treatment) [8]. …”

Section: Discussionmentioning

confidence: 99%

“…Yet little research on predictors of premature termination of treatment for PD exists. Previous research of various forms of treatment for PD has shown that factors such as age [7], interpersonal distress [8], and impulsiveness [9] may be important for predicting premature termination. Other studies of day treatment for mixed populations have identified level of interpersonal maturity [10], psychological mindedness [11], and level of education [12] as important predictors.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Premature Termination of Day Treatment for Personality Disorder

Ogrodniczuk¹,

Joyce

Lynd

et al. 2008

Psychother Psychosom

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Background: Premature termination is a common problem in the treatment of personality disorder. Efforts to improve compliance should begin by recognising risk factors for premature termination. This prospective study identified predictors of premature termination from a day treatment program for personality disorder. Methods: Consecutively admitted patients with a personality disorder (n = 197) were assessed with self-report and interview measures. Patient personality characteristics were the primary predictors. Others were demographic, initial disturbance, and personality disorder variables. Cox proportional hazards regression was used. Results: Risk of terminating prematurely significantly increased if the patient had been previously hospitalised for psychiatric difficulties, was younger, had fewer prior contacts with health and social services, and had more severe borderline personality disorder traits. Conclusions: Information about which patients are at high risk for premature termination can help clinicians take measures to modify the risk. This might involve selection decisions, pre-treatment preparation, close monitoring during treatment, or addition of adjunctive interventions.

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“…Die Beurteilung des psychosozialen Funktionsniveaus dagegen (GAF) weist in der SET-Gruppe wieder auf große Effekte, in der SST-Gruppe nur auf mittlere Effekte hin. Verbesserungen der Emotionsregulation, des Copings und der erlebten Selbstwirksamkeit können wie folgt differenziert [Shea et al, 1990;Perry, 1993;Wierzbicki und Pekarik, 1993;Garfield, 1994;Reis und Brown, 1999;Thormählen et al, 2003] [Linehan et al, 1991;Koons et al, 2001;Verheul et al, 2003]. Auch von einer Implementierung der DBT in stationä-re Behandlungsangebote werden positive Behandlungsergebnisse berichtet [vgl.…”

Section: Deskription Mittels Effektstärkenunclassified

Schemazentrierte emotiv-behaviorale Therapie (SET): Eine randomisierte Evaluationsstudie an Patienten mit Persönlichkeitsstörungen aus den Clustern B und C

Zorn¹,

Roder²,

Müller³

et al. 2007

Verhaltenstherapie

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Hintergrund: Bislang herrscht ein erheblicher Mangel an Gruppentherapieverfahren für Patienten mit unterschiedlichen Persönlichkeitsstörungen. Vor diesem Hintergrund entwickelte unsere Arbeitsgruppe einen neuen manualisierten Therapieansatz, der schematherapeutische, emotionszentrierte, kognitive und verhaltenstherapeutische Methoden integriert, die «Schemazentrierte emotiv-behaviorale Therapie» (SET). Patienten und Methoden: Randomisierter Kontrollgruppenvergleich zwischen der SET und einem Therapieverfahren zur Verbesserung sozialer Fertigkeiten mit insgesamt 93 ambulanten oder teilstationären Patienten mit einer Persönlichkeitsstörung der Cluster B oder C (DSM-IV). Ergebnisse: Signifikant stärkere Verbesserungen lassen sich in der SET-Gruppe bei den interpersonalen Verhaltensweisen, dem emotionalen Coping und den symptomatischen Beeinträchtigungen nachweisen. Klinisch relevante Effekte zugunsten der SET finden sich in der Reduktion des Leidensdrucks, des Störungsgrades und der Hoffnung auf Besserung. Daneben wird in der SET-Gruppe eine hochsignifikant niedrigere Dropout-Rate bzw. eine signifikant stärkere Nutzung des Therapieangebots beobachtet. Vergleichbar sind die Therapieergebnisse beider Gruppen im Bereich des behavioralen Copings und der Selbstwirksamkeit. Diskussion und Schlussfolgerungen: Mit der SET scheint ein Therapieansatz vorzuliegen, der bei Patienten mit Persönlichkeitsstörungen auf hohe Akzeptanz stößt und eine effiziente Behandlung im Gruppensetting ermöglichen könnte. Auch unter klinischen und ökonomischen Gesichtspunkten könnte die SET einen wichtigen Beitrag für die bestehende Krankenversorgung leisten.

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Patient Factors Predicting Dropout from Supportive-Expressive Psychotherapy for Patients with Personality Disorders

Cited by 57 publications

References 26 publications

Helping alliance and early dropout from psychiatric out-patient care

Helping alliance and early dropout from psychiatric out-patient care

Predictors of Premature Termination of Day Treatment for Personality Disorder

Schemazentrierte emotiv-behaviorale Therapie (SET): Eine randomisierte Evaluationsstudie an Patienten mit Persönlichkeitsstörungen aus den Clustern B und C

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