UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Community-based psychodynamic treatment program for severe personality disorders: clinical description and naturalistic evaluation

Chiesa, M; Fonagy, P; Gordon, J; (2009) Community-based psychodynamic treatment program for severe personality disorders: clinical description and naturalistic evaluation. Journal of Psychiatric Practice , 15 (1) 12 - 24. 10.1097/01.pra.0000344915.61706.d4. Green open access

[img]
Preview
PDF
Fonagy_template_Chiesa_with_RR_review_comments_changes_accepted.pdf

Download (229kB)

Abstract

Long-term inpatient treatment for personality disorders has become infrequent in the last two decades, and the gap left in service provision has been filled by psychodynamically and cognitively oriented partial hospitalization and outpatient, community-based approaches. It is still uncertain how these low-cost, lower-intensity models have fared relative to residential models that treat patients with severe personality disorders with the containment and control offered by the inpatient setting. In this article, we describe key features of a community-based psychodynamic program developed at the Cassel Hospital in the United Kingdom and present preliminary findings of a 2-year prospective naturalistic outcome study that monitored psychiatric morbidity (Brief Symptom Inventory General Severity Index [BSI-GSI]) and clinical outcome (self-mutilation, suicide attempts, and hospital admissions) in 68 patients with personality disorders who were consecutively admitted to the program. Improvements shown by the community-based sample on all variables were compared with the results in a comparable sample of inpatients treated in a long-term psychosocial treatment program in the same institution. The naturalistic comparison of the two non-randomized treatment models revealed that the community-based sample improved to a significantly greater degree on all three clinical outcome dimensions and had significantly lower early dropout rates than those who received the long-term residential treatment. The findings indicate that, at least in terms of impulsive behavior and treatment adherence, the community-based program appears to offer a viable adequate alternative to long-term inpatient admission. (Journal of Psychiatric Practice 2009;15:12-24)

Type: Article
Title: Community-based psychodynamic treatment program for severe personality disorders: clinical description and naturalistic evaluation
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/01.pra.0000344915.61706.d4
Publisher version: http://dx.doi.org/10.1097/01.pra.0000344915.61706....
Language: English
Additional information: "This is a non-final version of an article published in final form in hiesa, M; Fonagy, P; Gordon, J; (2009) Community-based psychodynamic treatment program for severe personality disorders: clinical description and naturalistic evaluation. Journal of Psychiatric Practice , 15 (1) 12 - 24."
Keywords: Personality disorders, Borderline personality disorder, Psychodynamic treatment, Community-based treatment, Outcomes, Self-harm, Suicide, Long-term inpatient treatment, Randomized controlled-trial, Borderline patients, Psychotherapy, Hospitalization
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/150222
Downloads since deposit
315Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item