Mentalization-based therapy adherence and competence stimulates in-session mentalization in psychotherapy for borderline personality disorder with co-morbid substance dependence

Möller, Clara; Karlgren, Linda; Sandell, A.-C.; Falkenström, Fredrik; Philips, Björn

doi:10.1080/10503307.2016.1158433

Cited by 59 publications

(54 citation statements)

References 51 publications

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“…For instance, MBT fidelity warrants attention, given that recent research by Folmo et al . () has showed that MBT fidelity can be measured reliably, whilst Möller, Karlgren, Sandell, Falkenström, and Philips () showed that adhering to MBT competencies was associated with increased in‐session mentalizing capacity.…”

Section: Discussionmentioning

confidence: 99%

Mentalization‐based treatment and its evidence‐base status: A systematic literature review

Malda-Castillo

Browne²,

Algorta

2018

Psychol Psychother

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MBT can be a particularly effective intervention for the treatment of adults with a diagnosis of BPD and of adolescents who self-harm and mothers enrolled in substance abuse treatments. MBT can be an effective intervention for depression and eating disorders but the evidence is currently limited. Professionals supporting mothers of children at risk may benefit from receiving training in the principles of MBT.

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Section: Discussionmentioning

confidence: 99%

Mentalization‐based treatment and its evidence‐base status: A systematic literature review

Malda-Castillo

Browne²,

Algorta

2018

Psychol Psychother

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“…There was one near significant finding (Mann-Whitney p = 0.06) that demonstrated the MBT group had no suicide attempts during treatment, versus four in the control group (Philips, 2016). However, we cannot know for sure that treatment in this study was MBT proper since adherence was low (Karterud & Bateman, 2010;Möller, Karlgren, Sandell, Falkenström, & Philips, 2016;Philips, 2016).…”

Section: /30mentioning

confidence: 91%

Mentalization-based treatment for female patients with comorbid personality disorder and substance use disorder: A pilot study

et al. 2017

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Mentalization-based treatment for female patients with comorbid personality disorder and substance use 28/30 disorder: A pilot study Objectives: In this study, we investigated the feasibility of mentalization-based treatment (MBT) for patients with comorbid substance use disorder (SUD) and borderline personality disorder (BPD). No published study has ever specifically looked at MBT for these patients. Such individuals are known to have a very poor prognosis and harbor much pain and misery. Moreover, few randomized controlled trials exist on psychotherapy efficiency for patients with comorbid substance use disorder and borderline personality disorder. There is an urgent need for more knowledge on treatment for this patient group. Design: A pilot project within a naturalistic clinical setting with longitudinal data collection during treatment and at follow-up. Eighteen female patients attended a pilot project and participated in up to 36 months of treatment, according to the manuals. Patients were measured on primary (pre/post) and secondary (longitudinal) outcome measures before treatment, every six months during treatment, at the end of treatment, and at follow-up approximately two years after treatment. Methods: Statistical analyses of repeated outcome measures (GSI, CIP, GAF, WSAS, and RSES) and of pre/post measures (Axis I and II diagnosis) were performed with linear mixed models, and Cohens d was calculated. Results: Significant improvements on primary and secondary outcome measures were demonstrated, with effect sizes ranging from moderate to large. With respect to primary outcome, these SUD/PD patients were almost fully recovered from their SUD at follow-up (a predicted score of 0.2 Axis I SUD diagnosis at follow-up in comparison with a score of 1.8 at baseline). Conclusion: MBT as performed in this pilot project indicates promising results for patients with (mostly borderline) PDs and comorbid SUDs. Performing RCT studies is warranted.

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“…An important way of investigating the usefulness of competence as a concept will be to examine the convergence of competence ratings with outcome measures. Few of the studies included here measured this, although there is further research available into links between competence and outcome in specific models of therapy; for example, a study by Möller, Karlgren, Sandell, Falkenström, and Philips () found that higher levels of therapist competence in mentalization‐based therapy predicted higher levels of reflective functioning in clients. A previous review and meta‐analysis did not find a significant relationship between competence ratings and outcome measures (Webb, DeRubeis, & Barber, ); however, the authors state that the results should be interpreted with caution due to the varied methods and samples of the studies included.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of measures of therapist competence in psychodynamic, interpersonal, and/or relational models

Barlow¹,

Brown

2019

Psychol Psychother

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Psychotherapy Services, Manchester Academic Health Sciences Centre, Greater Manchester Mental Health NHS Foundation Trust, UKPurpose. Assessment of psychotherapeutic competence is increasingly regarded as important in the delivery of psychological services and training programmes. This article reviews tools designed to assess clinical competence in psychodynamic, interpersonal, and relational models of therapy.Methods. PsycINFO, CINAHL, and Web of Science online databases were reviewed using terms relating to competence, psychotherapy, and measurement. Titles and abstracts of all articles were screened, and full texts of remaining articles were read. Reference lists of included articles were also screened. Papers that described a measure of psychotherapeutic competence in a psychodynamic, interpersonal, or relational model, and reported at least one assessment of the reliability and/or validity of the measure, were included. The quality of the studies was evaluated, and the quality of individual measures was summarized.Results. Fourteen studies met the inclusion criteria, examining 13 competence measures for 12 specific models of therapy. Competence measures were not found for several NICE-recommended models of therapy. Some measures demonstrated strengths in certain areas of reliability and validity; however, there were a number of quality issues in development and psychometric properties that suggest none of the measures are currently proven for widespread use.Conclusions. Further research is required to refine currently existing measures and develop new measures for key NICE-recommended models of therapy. Practitioner pointsAssessment and improvement of therapist competence is key to provision of high-quality psychotherapeutic interventions. This review shows there are few measures of competence in relational therapy models and several NICE-recommended models do not have corresponding competence measures.

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Mentalization-based therapy adherence and competence stimulates in-session mentalization in psychotherapy for borderline personality disorder with co-morbid substance dependence

Cited by 59 publications

References 51 publications

Mentalization‐based treatment and its evidence‐base status: A systematic literature review

Mentalization‐based treatment and its evidence‐base status: A systematic literature review

Mentalization-based treatment for female patients with comorbid personality disorder and substance use disorder: A pilot study

A systematic review of measures of therapist competence in psychodynamic, interpersonal, and/or relational models

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