Page 47 - Personality disorders and insecure attachment among adolescents

occurred for which respondent, regardless of the number of times the factors occurred per respondent. The inter-rater reliability qualified as almost perfect (k = 0.83) (Landis & Koch, 1977).
The therapeutic factor ‘cohesion’ was most recognized by both psychologists, and ‘family re- enactment’ the least. Only factors about which the raters agreed were used; factors for which there was no agreement were not used in further analyses. Some therapeutic factors (2, 5, 8) were mentioned by almost every participant while others occurred almost never (3, 9, 11). Because the aim of this study was to identify factors that differentiated between successful and unsuccessful treatments, factors that were not expected to differentiate because of low or high frequency were excluded from further analysis.
Statistical analysis
All quantitative analyses were performed using the Statistical Package for the Social Sciences, version 23.0 (IBM Corp, 2011). To operationalize therapeutic success, an SCL-90 outcome score was composed by subtracting the post-treatment total score from the total pre-treatment score. To compare the total score on the SCL-90 at the beginning of treatment with the end of treatment an ANOVA was used. Next, it was investigated which of the 12 plus four additional therapeutic factors correlated with this SCL-90 outcome score. Linear regression analysis was used to explore the relationship between the predictor variables (therapeutic factors) and the SCL-90 outcome scores.
Results
Results of content analysis
When comparing the pre- and post-treatment SCL-90 total data, a significant decrease in symptoms was found (t = 7.257, p = .000). The mean t-1 total score of 238.36 (SD = 50.93) on the SCL-90 declined to 186.86 (SD = 62.96) at t-2 (d = .90, 95% CI [37.34-65.66]). Content analysis of the 70 farewell letters showed that the patients generally summarised their struggles before treatment, followed by a description of the therapeutic process and the contact with group members and treatment staff. Most letters followed the same structure, starting with a salutation to the patient group and a description of how it feels to say goodbye; this was followed by a narrative of the participant’s mental state and struggle before or at the start of treatment, and a first impression of the patient group and group psychotherapy culture at the start of treatment. They described the psychotherapeutic interventions and contact with other patients, staff members, and loved ones. Many people mentioned the high points in the therapeutic programme, such as camping, practical jokes, and the changes they made, and ended by thanking and empowering the group members.
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