University Institute of Psychotherapy, Department of Psychiatry, University of Lausanne, Switzerland.
Clin Psychol Psychother. 2013 Jan-Feb;20(1):1-9. doi: 10.1002/cpp.784. Epub 2011 Sep 1.
A comprehensive understanding of the patient's problems is essential for a constructive therapeutic behaviour, especially in borderline personality disorder (BPD) where difficult interpersonal patterns are persistent. In these circumstances, the use of an integrative case formulation approach such as Plan Analysis, developed by K. Grawe and F. Caspar, can be of help for therapy planning. The focus here is on instrumental relations between behaviours and the hypothetical Plans and motives 'behind' those behaviours. The present qualitative study aimed at setting a prototypical Plan structure for n = 15 patients presenting a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnosis of BPD using Plan Analysis. The first psychotherapeutic session of every outpatient was video-taped and evaluated according to the Plan Analysis procedure. Inter-rater reliability was established between two independent raters and was considered sufficient. The detailed prototypical Plan structure of BPD showed two main tendencies: first, the important presence of support-seeking among these patients and second, the will to be in control and to protect oneself. This study confirms the existence of several core similarities in the functioning of patients with BPD. These findings are in line with earlier studies and expand the latter with the aim of contributing to the understanding of BPD psychopathology. Clinical implications are discussed.
全面了解患者的问题对于建设性的治疗行为至关重要，特别是在边缘型人格障碍（BPD）中，人际模式困难且持续存在。在这种情况下，使用综合病例制定方法，如 K. Grawe 和 F. Caspar 开发的计划分析，可以帮助制定治疗计划。重点关注行为之间的工具性关系以及这些行为背后的假设计划和动机。本定性研究旨在使用计划分析为 n = 15 名被诊断为边缘型人格障碍的患者制定典型的计划结构。每位门诊患者的第一次心理治疗会话都进行了录像，并根据计划分析程序进行了评估。两位独立评估者之间建立了组内信度，认为其充分可靠。BPD 的详细典型计划结构显示出两种主要倾向：首先，这些患者中重要的寻求支持的存在，其次是控制和保护自己的意愿。这项研究证实了 BPD 患者功能存在几个核心相似之处。这些发现与早期研究一致，并扩展了后者，旨在帮助理解 BPD 病理心理学。讨论了临床意义。
