Page 56 - Personality disorders and insecure attachment among adolescents

15. Resilience
16. Epistemic trust
change in the group therapy
The belief that one can cope with stressful life events
Learning to trust and learn from other people
11 15.7 9 12.9
Among the 11 therapeutic factors left for analysis, a significant correlation was found between the SCL-90 score change and three therapeutic factors. These factors were ‘interpersonal learning input’ (r = .336, p = .004), ‘self-esteem’ (r = .241, p = .044) and ‘turning point’ (r = .324, p = .006). Multiple regression was then used to assess whether these three Yalom factors (4, 13, 14) accurately predicted the SCL-90 score change. Preliminary analyses were conducted to ensure there were no violations of the assumptions of normality, linearity, multicollinearity and homoscedasticity. All three therapeutic factors were entered together into the model. The total variance explained by the model was 22.4% (F (3, 66) = 6.35; p = .001). Each of the three factors made a unique and statistically significant contribution to the model. The strongest predictor was ‘interpersonal learning input’, which contributed 6.5% to the variance, followed by ‘self-esteem’ (5.8%) and ‘turning point’ (5.1%).
Discussion
The aim of this mixed-method study was to investigate whether the therapeutic factors proposed by Yalom, with potential additional therapeutic factors, featured in letters written by recovering adolescents after completing an intensive group psychotherapeutic MBT. In addition, the relationships between these therapeutic factors and changes in symptom scores were explored. In 70 farewell letters written (without instruction) by a high-risk adolescent sample, all the therapeutic factors of Yalom (Yalom & Leszcz, 2005) were identified in association with resilience processes and the resolution of psychological distress among the participants. Large differences were observed in the
number of respondents who mentioned specific therapeutic factors. The factors of ‘cohesion’, ‘interpersonal learning output’, ‘guidance’ and ‘identification’ were almost always mentioned, and are therefore considered important among adolescents with personality pathology. These therapeutic factors seem to be a precondition for variables that were associated with therapeutic success. Therefore, although it would be premature to propose firm clinical implications based on these findings, the data indicate with great caution that it may be beneficial for clinicians to consider certain focus points in intensive group psychotherapy for adolescents with personality disorders. Clinicians could focus on the following issues, in addition to the common therapeutic factors: a) how the group
50