“Yes, there is actually hope!”—A qualitative investigation of how patients experience mentalization-based psychoeducation tailored for borderline personality disorder.

Abstract

Common factors, such as the working alliance, positive expectations, and psychoeducation have been robustly related to outcome in studies of psychotherapy. As a multicomponent treatment for borderline personality disorder (BPD), Mentalizationbased treatment (MBT) includes introductory group-based psychoeducation on core features of personality functioning, BPD, the treatment program and disorder-related personal management. Generally, few studies have investigated patients' views on how psychoeducation works. This study aimed to explore their experience of the group-based psychoeducation. Twelve patients who had attended the introductory group-based psychoeducation in MBT participated. Qualitative interviews were analyzed using Interpretative Phenomenological Analysis. MBT psychoeducation was found helpful in itself and in the further treatment process. Identified experiences related to the group (feeling less ashamed, learning from others, feeling different from others), acquisition of "tools" for better personal management (the psychoeducational content; putting new knowledge into practice), preparation for longer term therapy (therapy became more trustworthy, easier to understand, felt more effective), and demanding aspects (problems with attendance or concentration). This qualitative study is the first to present patients' own experiences of psychoeducation as part of MBT and suggests that psychoeducation is a powerful and facilitating intervention. Careful patient selection may further optimize its potential.

Pedagogical stance in mentalization‐based treatment

“…A “pedagogical stance” is recently proposed as an intervention in MBT (Karterud et al, 2020) and seems supported in the present study, former studies focusing on the alliance, epistemic trust, and psychoeducation in MBT (Ditlefsen et al, 2020; Folmo et al, 2020; Sharp et al, 2020). As the MBT manual now promotes such interventions, new empirical studies can be performed.…”

“…According to the theory of mentalization, the establishment of epistemic trust between the teacher and the learner is essential for communication to be accepted as meaningful and relevant (Luyten et al, 2020; Wilson & Sperber, 2012). Interestingly, in a qualitative MBT study, BPD patients expressed high satisfaction with the initial psychoeducational group (Ditlefsen et al, 2020). Patients emphasized an expanded understanding and vocabulary for mental states, and that positive learning experiences facilitated their hope and trust in treatment.…”

Improvement of personality functioning among people treated within personality disorder mental health services. A longitudinal, observational study

“…Treatments designed for PD often focus on key features of personality functioning [Laurenssen et al, 2014; ( 25 ), such as emotional dysregulation ( 104 , 105 ), awareness of affects ( 106 ), mentalizing and interpersonal functioning ( 107 ), and in PD therapies, systematic co-creation of individual case formulations addressing such problems is recommended ( 108 )]. Use of pedagogical interventions and psychoeducation may also strengthen commitment and motivation in treatment for PD ( 109 – 111 ). In our sample, approximately 50% received psychoeducation as part of a manualized program, and additionally 21% attended a standalone MBT psychoeducation.…”

L’expérience des participantes au programme STEP : une intervention prénatale pour les femmes ayant subi de mauvais traitements durant leur enfance

“…Ces résultats résonnent avec les propos de participants ayant pris part à des interventions partageant des points communs avec le programme STEP. D'abord, une étude évaluant l'expérience d'adultes souffrant d'un trouble de la personnalité limite à une approche psychoéducative de groupe basée sur la mentalisation, le paradigme conceptuel au coeur des activités du programme STEP, rapporte que le format de groupe a nettement contribué à diminuer les sentiments de honte éprouvés par les participants et leur a permis d'apprendre des autres (Ditlefsen et al, 2021). Ensuite, une étude qualitative réalisée auprès de femmes enceintes ayant reçu des soins prénataux en format de groupe a rapporté que le collectif les amenait à se sentir soutenues, connectées aux autres femmes et à percevoir que d'autres femmes enceintes avaient une expérience similaire à la leur (McNeil et al, 2012).…”