Working Alliance Instability in the Inpatient Treatment of Borderline Personality Disorder

IF 1.5 Q3 PSYCHOLOGY, CLINICAL JOURNAL OF CONTEMPORARY PSYCHOTHERAPY Pub Date : 2024-06-03 DOI:10.1007/s10879-024-09630-0
Leonhard Kratzer, Josefine Moultrie, Günter Schiepek
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Abstract

Borderline personality disorder (BPD) is characterized by a pathognomonic instability of interpersonal relationships. Therefore, a good working alliance in the treatment of BPD may go beyond qualitative aspects like agreement on goals and mutual trust, and in particular depend on a balancing of instability. Yet, little is known about working alliance dynamics in the treatment of BPD. Using daily ratings of the Therapy Process Questionnaire, we retrospectively investigated assessments of the stability of the therapeutic alliance during inpatient treatment in 51 patients with BPD and 66 patients with major depressive disorder. Regression analyses were used to investigate whether working alliance was more unstable in patients with BPD and how it was associated to outcome. The working alliance was found to be significantly more unstable in patients with BPD. Yet, a high dynamic complexity of the working alliance was found to be linked to better outcomes in BPD, possibly hinting at the importance of rupture and repair.

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边缘型人格障碍住院治疗中工作联盟的不稳定性
边缘型人格障碍(BPD)的特点是人际关系不稳定。因此,在治疗边缘型人格障碍的过程中,良好的工作联盟可能不仅仅局限于就目标达成一致和相互信任等质量方面,尤其取决于对不稳定性的平衡。然而,人们对 BPD 治疗中的工作联盟动态却知之甚少。通过对治疗过程问卷的每日评分,我们对 51 名 BPD 患者和 66 名重度抑郁症患者住院治疗期间治疗联盟稳定性的评估进行了回顾性调查。我们使用回归分析来研究工作联盟在 BPD 患者中是否更不稳定,以及它与治疗结果的关系。结果发现,BPD 患者的工作联盟明显更不稳定。然而,研究发现,工作联盟的高动态复杂性与 BPD 患者更好的预后有关,这可能暗示了破裂和修复的重要性。
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来源期刊
CiteScore
4.40
自引率
5.00%
发文量
44
期刊介绍: Journal of Contemporary Psychotherapy provides an international forum to critique the complexities and controversies facing psychotherapists. The journal publishes original peer-reviewed articles that critically analyze theory, research, or clinical practice. Empirical studies, panel discussions, essays, case studies, brief reports, and theoretical articles are published. Psychotherapists and clinical researchers will find this journal an important vehicle to review the problems of treating a variety of patients.
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