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基于心理化的治疗依从性和能力会激发共病物质依赖的边缘型人格障碍心理治疗中的治疗室内心理化。

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

机构信息

a Department of Behavioral Sciences and Learning , Linköping University , Linköping , Sweden.

b Center for Clinical Research Sörmland , Uppsala University , Uppsala , Sweden.

出版信息

Psychother Res. 2017 Nov;27(6):749-765. doi: 10.1080/10503307.2016.1158433. Epub 2016 Apr 19.

Abstract

OBJECTIVE

To test whether adherence to mentalization-based treatment (MBT) principles predict better patient in-session mentalizing.

METHODS

Two sessions for each of 15 patients with borderline personality disorder and comorbid substance abuse disorder were rated for MBT adherence and competence. Individual patient statements were rated for Reflective Functioning (RF), therapist statements were rated as demanding RF or not. Data were analysed using multilevel modelling.

RESULTS

MBT adherence and competence predicted higher session RF (β = .58-.75), even while controlling for pre-treatment RF. In addition, therapist interventions directed toward exploring mental states predicted higher RF of subsequent patient responses (β = .11-.12).

CONCLUSIONS

MBT adherence and competence were significantly related to patient in-session mentalizing, supporting the validity of MBT principles. Results point to the importance of supervision for therapists to become adherent to MBT principles. The small number of patients and sessions limits generalizability of results.

摘要

目的

检验是否遵循心理化治疗(MBT)原则能够预测患者在治疗过程中的更好的心理化水平。

方法

对 15 名患有边缘型人格障碍和合并物质滥用障碍的患者进行了两次治疗,每次治疗都对 MBT 依从性和能力进行了评估。对每位患者的个体陈述进行了反映功能(RF)评估,对治疗师的陈述进行了是否需要 RF 评估的评估。使用多层模型进行数据分析。

结果

MBT 依从性和能力预测了更高的治疗过程 RF(β=0.58-0.75),即使在控制了治疗前 RF 之后也是如此。此外,治疗师探索心理状态的干预措施预测了随后患者反应的更高 RF(β=0.11-0.12)。

结论

MBT 依从性和能力与患者在治疗过程中的心理化水平显著相关,支持 MBT 原则的有效性。结果表明,监督治疗师遵守 MBT 原则非常重要。患者和治疗次数的数量较少限制了结果的普遍性。

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