Is Mentalization a Common Process Factor in Transference-Focused Psychotherapy and Dialectical Behavior Therapy Sessions? (original) (raw)
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The British journal of psychiatry : the journal of mental science, 2015
Borderline personality disorder is associated with deficits in personality functioning and mentalisation. In a randomised controlled trial 104 people with borderline personality disorder received either transference-focused psychotherapy (TFP) or treatment by experienced community therapists. Among other outcome variables, mentalisation was assessed by means of the Reflective Functioning Scale (RF Scale). Findings revealed only significant improvements in reflective function in the TFP group within 1 year of treatment. The between-group effect was of medium size (d = 0.45). Improvements in reflective function were significantly correlated with improvements in personality organisation.
Dialogues in Clinical Neuroscience & Mental Health 4 (2), 91-104, 2021
Borderline personality disorder (BPD) is a persistent pattern of instability in terms of emotion regulation, impulsiv-ity, self-image, interpersonal relationships with extreme 'splitting' between idealisation and devaluation of others, including also stress-related paranoid ideation and dissociative symptoms. Self-harming behaviour is also common amongst BPD patients. The manifestation of these symptoms may lead to serious disturbances of quality of life for patients, families and their significant others along with problems in professional and personal development. Several evidence-based psychotherapeutic approaches have been developed to address these issues. In this review two of them were put into scrutiny; Dialectical Behaviour Therapy or DBT, and Transference-Focused Psychotherapy or TFP. These were reviewed by examining RCT studies published in Cochrane and Clinicaltrials.gov databases. The efficacy of these two interventions was examined on similar outcomes, such as therapy dropout, general BPD symptoms, global functioning, self-harm, and social adaptation. No prominent superiority for either of the treatments in comparison was identified, however both TFP and DBT show greater efficacy when compared to other, non-BPD specific psychotherapeutic approaches.
Journal of Consulting and Clinical Psychology, 2006
Changes in attachment organization and reflective function (RF) were assessed as putative mechanisms of change in 1 of 3 year-long psychotherapy treatments for patients with borderline personality disorder (BPD). Ninety patients reliably diagnosed with BPD were randomized to transference-focused psychotherapy (TFP), dialectical behavior therapy, or a modified psychodynamic supportive psychotherapy. Attachment organization was assessed with the Adult Attachment Interview and the RF coding scale. After 12 months of treatment, participants showed a significant increase in the number classified secure with respect to attachment state of mind for TFP but not for the other 2 treatments. Significant changes in narrative coherence and RF were found as a function of treatment, with TFP showing increases in both constructs during treatment. No changes in resolution of loss or trauma were observed across treatments. Findings suggest that 1 year of intensive TFP can increase patients' narrative coherence and RF. Future research should establish the relationship between these 2 constructs and relevant psychopathology, identify treatment components responsible for effecting these changes, and examine the long-term outcome of these changes.
2021
Borderline personality disorder (BPD) is a persistent pattern of instability in terms of emotion regulation, impulsivity, self-image, interpersonal relationships with extreme ‘splitting’ between idealisation and devaluation of others, including also stress-related paranoid ideation and dissociative symptoms. Self-harming behaviour is also common amongst BPD patients. The manifestation of these symptoms may lead to serious disturbances of quality of life for patients, families and their significant others along with problems in professional and personal development. Several evidence-based psychotherapeutic approaches have been developed to address these issues. In this review two of them were put into scrutiny; Dialectical Behaviour Therapy or DBT, and Transference-Focused Psychotherapy or TFP. These were reviewed by examining RCT studies published in Cochrane and Clinicaltrials.gov databases. The efficacy of these two interventions was examined on similar outcomes, such as therapy d...
Psychodynamic Psychotherapy Research, 2011
It is generally believed that psychoanalytically or dynamically oriented clinicians are not interested in research for a host of reasons ranging from the challenges of designing a randomized controlled trial that would demonstrate the effi cacy of a psychoanalytic approach to epistemological and philosophical disagreements about the nature of science (see debates for an illustration). Although many in the psychoanalytic community have in the past been cautious regarding the value of research, some of the earliest psychotherapy research was performed by psychoanalysts . Additionally, psychoanalyst and psychodynamic clinicians are increasingly becoming interested in testing psychodynamic hypotheses and establishing a stronger evidence base for treatments based on psychodynamic ideas . This increased interest in psychotherapy outcome research has been particularly fruitful with regard to the study of borderline personality disorder. Severe personality disorders such as borderline personality disorder are increasingly seen as the mainstay of psychoanalytic clinical work.
Studies in Medical Sciences, 2020
Background & Aims: The purpose of the present study was to investigate the changes in borderline personality structure at different time serials of treatment. Materials & Methods: The present study is a quasi-experimental and single-subject (A/B) study. The sample of study was a 35-year-old man who was selected as a borderline personality disorder among the patients referred to Health Center through a preliminary clinical interview and performing Millon clinical multiaxial inventory -III (MCMI-III) by available sampling method. The interview with the Semi-Structured Interview of the Personality Organization (STIPO) was conducted in four stages including one pre-test and three post-tests after time series treatment. Single-Subject was studied for 11 months in a format of 51 sessions of transference focused psychotherapy. Results: The findings showed that the mean scores of personality structure (identity, dimensions of object relations, aggression, personality rigidity, deference mechanisms, and morality) in the first post-test were not significantly different from the pre-test; but there was a significant clinical difference in the mean scores of personality structure at the second and third post-tests compared to the pre-test. Conclusion: Based on the results, this treatment has significant effect in improving the personality dimensions of borderline patients, especially in advanced stages of treatment.
Two psychiatric inpatients with borderline personality disorder (BPD) participated in 5 months of three-times-per-week psychodynamic therapy (PDT). Patients completed a measure of psychological distress every week. Forty-four sessions were audiotaped and coded using the Psychotherapy Process Q-Set (PQS) and correlated with PQS prototypes of five treatment models-PDT, cognitive-behavior therapy (CBT), interpersonal therapy (IPT), transference-focused psychotherapy (TFP), and dialectical behavior therapy (DBT). Prototypical CBT process was significantly more prevalent in Patient 1's than in Patient 2's treatment. In both treatments combined, prototypical PDT process significantly decreased over time, prototypical CBT process was negatively correlated with distress, and prototypical TFP process was positively correlated with distress. Two PQS items-therapist aloofness and patient feeling inadequate and inferior-were positively correlated with distress for Patient 2. An effective PDT treatment model for severely disturbed BPD inpatients requires technical flexibility to make temporary use of more structured interventions that serve the treatment goal of stabilization.
DOAJ (DOAJ: Directory of Open Access Journals), 2021
Borderline personality disorder (BPD) is a persistent pattern of instability in terms of emotion regulation, impulsivity, self-image, interpersonal relationships with extreme 'splitting' between idealisation and devaluation of others, including also stress-related paranoid ideation and dissociative symptoms. Self-harming behaviour is also common amongst BPD patients. The manifestation of these symptoms may lead to serious disturbances of quality of life for patients, families and their significant others along with problems in professional and personal development. Several evidence-based psychotherapeutic approaches have been developed to address these issues. In this review two of them were put into scrutiny; Dialectical Behaviour Therapy or DBT, and Transference-Focused Psychotherapy or TFP. These were reviewed by examining RCT studies published in Cochrane and Clinicaltrials.gov databases. The efficacy of these two interventions was examined on similar outcomes, such as therapy dropout, general BPD symptoms, global functioning, self-harm, and social adaptation. No prominent superiority for either of the treatments in comparison was identified, however both TFP and DBT show greater efficacy when compared to other, non-BPD specific psychotherapeutic approaches.