Institute of Psychology, Faculty of Social and Political Science, University of Lausanne, Lausanne, Switzerland.
Department of Psychiatry, Community Psychiatry Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
PLoS One. 2024 Mar 15;19(3):e0299514. doi: 10.1371/journal.pone.0299514. eCollection 2024.
People with borderline personality disorder have difficulties with work. The Individual Placement and Support model has shown its worldwide effectiveness in terms of vocational rehabilitation for individuals with psychiatric disorders. However, only a few recent studies have explored its results for people with personality disorders, and the findings were mitigated. Additionally, Individual Placement and Support job coaches reported difficulties in supporting this population. An evidence-based psychotherapeutic method, also applicable in a case management context, called Good Psychiatric Management for borderline personality disorder, could potentially overcome these obstacles. This study aimed to evaluate the initial integration of Good Psychiatric Management in Individual Placement and Support practice.
Individual Placement and Support practitioners of Lausanne University Hospital, Switzerland, were trained in Good Psychiatric Management in January 2022. Five of them participated in a focus group to collect their impressions about the training, and six were interviewed 9 months later to assess the initial adoption of Good Psychiatric Management into their practice. Thematic analyses were conducted.
Job coaches were positive about this new tool. All of them found it useful and beneficial both for them and their patients. They were able to follow the main Good Psychiatric Management principles in their practice However, the findings also suggested some additional improvements in the implementation process.
Integrating Good Psychiatric Management in Individual Placement and Support seems feasible, and the team who appreciated it adopted it. The method offers new perspectives in community support for people living with borderline personality disorder.
边缘型人格障碍患者在工作中存在困难。个体安置与支持模式在精神障碍患者的职业康复方面已显示出其在全球范围内的有效性。然而,仅有少数近期研究探讨了其对人格障碍患者的效果,且结果较为缓和。此外,个体安置与支持的工作指导员报告称,支持这一人群存在困难。一种基于证据的心理治疗方法,也可应用于病例管理情境,称为“边缘型人格障碍的良好精神科管理”,可能会克服这些障碍。本研究旨在评估“良好精神科管理”在个体安置与支持实践中的初步整合。
瑞士洛桑大学医院的个体安置与支持从业者于 2022 年 1 月接受了“良好精神科管理”培训。其中 5 人参加了焦点小组,以收集他们对培训的印象,6 人在 9 个月后接受了访谈,以评估“良好精神科管理”在其实践中的初步采用情况。采用主题分析法进行分析。
工作指导员对这一新工具持积极态度。他们都认为这个工具有用且有益,无论是对他们自己还是对他们的患者。他们能够在实践中遵循“良好精神科管理”的主要原则。然而,研究结果也表明在实施过程中需要进一步改进。
将“良好精神科管理”纳入个体安置与支持似乎是可行的,且赞赏该方法的团队已经采用了它。该方法为边缘型人格障碍患者的社区支持提供了新的视角。