Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.
Psychol Psychother. 2019 Mar;92(1):20-38. doi: 10.1111/papt.12174. Epub 2018 Feb 13.
Limited empirical attention has been devoted to individualized treatment objectives in intensive group therapy for personality dysfunction. This study investigated patients' ratings of distress associated with individual therapy goals - referred to as target object severity - in an intensive Evening Treatment Programme for patients with personality dysfunction.
Change in target objective severity was examined in a sample of 81 patients who completed treatment in an intensive, integrative group therapy programme.
Correlation and regression analyses were used to examine associations between change in target object severity and patients' pre-treatment diagnosis, symptom distress, and treatment outcome expectancy, and between change in target objective severity and patients' ratings of group therapy process (group climate, therapeutic alliance, group cohesion). The relationship between change in target objective severity and longer-range life satisfaction was also examined in a subsample of patients who rated life satisfaction at follow-up.
While change in target objective severity was not significantly related to pre-treatment variables, significant associations were found with several aspects of group therapy process. Patients' experience of a highly engaged group climate was uniquely associated with improvement in target object severity. Such improvement was significantly related to longer-term life satisfaction after controlling for general symptom change.
The working atmosphere in group therapy contributes to patients' progress regarding individual treatment targets, and such progress is an important factor in later satisfaction. Attention to individualized treatment targets deserves further clinical and research attention in the context of integrative group therapy for personality dysfunction.
This study found that patients attending an integrative group treatment programme for personality dysfunction experienced significant improvement in severity of distress related to individual treatment objectives. Improvement in severity of distress related to individual treatment objectives was uniquely associated with patients' experience of an engaged, collaborative working atmosphere. Improvement in individual target objective severity was associated with patients' ratings of overall life satisfaction, rated an average of 9 months following termination, after controlling for change in general symptom severity.
在针对人格障碍的强化团体治疗中，针对个体治疗目标的个体化治疗关注有限。本研究调查了在针对人格障碍患者的强化晚间治疗计划中，患者对个体治疗目标相关痛苦（称为目标对象严重程度）的评估。
在完成强化综合团体治疗计划的 81 名患者样本中，检查了目标对象严重程度的变化。
使用相关和回归分析来检查目标对象严重程度变化与患者治疗前诊断、症状困扰和治疗预期结果之间的关联，以及目标对象严重程度变化与患者对团体治疗过程（团体氛围、治疗联盟、团体凝聚力）的评估之间的关联。在对随后对生活满意度进行评分的患者亚样本中，还检查了目标对象严重程度变化与更长期生活满意度之间的关系。
尽管目标对象严重程度的变化与治疗前的变量没有显著相关，但与团体治疗过程的几个方面存在显著关联。患者体验到高度投入的团体氛围与目标对象严重程度的改善有独特的关联。在控制一般症状变化后，这种改善与长期生活满意度显著相关。
团体治疗中的工作氛围有助于患者在个体治疗目标方面取得进展，而这种进展是后期满意度的重要因素。在针对人格障碍的综合团体治疗背景下，对个体化治疗目标的关注值得进一步的临床和研究关注。
本研究发现，参加人格障碍综合团体治疗计划的患者在与个体治疗目标相关的痛苦严重程度方面经历了显著的改善。与个体治疗目标相关的痛苦严重程度的改善与患者对参与、协作工作氛围的体验有独特的关联。在控制一般症状严重程度的变化后，目标对象严重程度的改善与患者对整体生活满意度的评估相关，这些评估是在治疗结束后平均 9 个月进行的。
