Page 80 - Personality disorders and insecure attachment among adolescents
P. 80

treatment and transitions into a day treatment halfway through the treatment process. The programme differs from the MBT programme for adolescents in England (Rossouw & Fonagy, 2012) in the psychodynamic group psychotherapy approach. The structured and integrated psychodynamic MBT milieu and group program is provided to adolescents between the ages of 16 and 23 who are clinically diagnosed as having personality disorders in combination with other non-psychotic disorders by a multidisciplinary team. Sufficient motivation for treatment is a prerequisite. The program offers weekly large group meetings, sociotherapy, group psychotherapy, art therapy, psychodrama therapy, psychomotor therapy, in combination with individual and family psychotherapy. These different therapies have a mentalizing focus on the adolescents’ subjective experience of themselves and others, and on the relationships with the group members and the therapists. The patients are not only taught to regulate their emotions better in contact with an another person yet also to question and adjust presuppositions about what someone might think about them. Especially situations in which it was no longer possible to mentalize are extensively discussed. In this manner a safe therapeutic community is established, in which is aimed not only to improve the mentalizing capacity of the adolescents yet also to diminish insecure attachment. As the therapy programme progresses, each group member gets more responsibilities towards participation in society, other group members and group psychotherapy culture. Medication is prescribed if necessary and according to protocol by a psychiatrist involved in the therapy program. Measures Patients completed a set of web-based questionnaires at the beginning and end of treatment including the Dutch Questionnaire for Personality Characteristics, or Vragenlijst voor Kenmerken van de Persoonlijkheid (VKP) (Duijsens et al., 1996). Subjects were assessed by the Structured Clinical Interview for DSM personality disorders (SCID-II) (Spitzer et al., 1990) and the Adult Attachment Interview (AAI) (Main et al., 1998). VKP The VKP is a questionnaire comprising 197 questions with two categories of answers, ‘true’ or ‘false’. The purpose of the VKP is to screen for personality disorders according to the DSM-IV. The test-retest reliability (Cohen’s Kappa) of the VKP on categorical diagnoses was moderate (k = .40) (Duijsens et al., 1996). Seeing that the VKP is known for its high sensitivity and low specificity (Duijsens et al., 1996), it is the recommended screening instrument for the Dutch version of the SCID- II (Dingemans & Sno, 2004; Verheul et al., 2000). The presumable and certain outcome of the VKP indicates which SCID-II personality disorder sections should be used. 76 


































































































   78   79   80   81   82