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Tailoring psychotherapy in patients with personality disorders: Matching the level of psychological strengths to the level of stabilizing versus destabilizing psychotherapy
Author(s) -
Van Manen Janine G.,
Horn Eva K.,
Stijnen Theo,
Timman Reinier,
Busschbach Jan J. V.,
Verheul Roel
Publication year - 2015
Publication title -
personality and mental health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 22
eISSN - 1932-863X
pISSN - 1932-8621
DOI - 10.1002/pmh.1281
Subject(s) - psychotherapist , psychology , clinical psychology , personality , personality disorders , matching (statistics) , psychodynamic psychotherapy , medicine , social psychology , pathology
Background Clinical evidence suggests that patients high on psychological strengths profit more from destabilizing psychotherapy, whereas patients low on strengths profit more from stabilizing psychotherapy. This matching hypothesis was tested. Methods This quasi‐experimental study was conducted between 2003 and 2008 in 735 patients with personality disorders from 6 psychotherapy centers in the Netherlands. Patients were assigned to different levels of stabilizing and destabilizing psychotherapies. Levels of psychological strengths were measured. We used multilevel modeling to estimate outcome at 12 months after baseline. The propensity score controlled for initial differences at baseline. Results The findings show that destabilizing psychotherapies have slightly better outcomes than stabilizing psychotherapies. Patients high on psychological strengths improve slightly more than patients low on psychological strengths. The observed interaction effect contradicted our hypothesis. Conclusion The results imply that destabilizing psychotherapies can be considered as first treatment option for patients both high and low on psychological strengths. Copyright © 2015 John Wiley & Sons, Ltd.