Abstract

Objective: Premature termination, or dropout, is a major concern in psychotherapy in general and an issue of particular importance in treatments for borderline personality disorder (BPD). Yet few studies investigating dropout from therapy in adolescent BPD populations exist. This study investigates reasons for dropping out from group-based mentalization-based treatment (MBT-G) for BPD or borderline features in an adolescent population.

Method: Ten semi-structured interviews were performed with female adolescents who had dropped out from group-based MBT for BPD. The data were analyzed qualitatively using Systematic Text Condensation.

Results: The results point to the existence of a subgroup of adolescent BPD patients who do not perceive the treatment sufficiently helpful or worthwhile, who experienced treatment as emotionally demanding, time-consuming and connected with unpleasant experiences. Positive reasons for early termination were reported in the form of experienced improvement in condition. Dropping out became understood as a process of weighing perceived benefits against perceived costs of staying in treatment. This understanding of dropout as a process implies the existence of a window of time where intervention to prevent dropout is possible, presupposing the detection of at-risk patients.

摘要

目的：过早终止或辍学是一般心理治疗中的主要关注点，在边缘性人格障碍（BPD）的治疗中尤为重要。然而，很少有研究调查青少年BPD人群因治疗辍学的研究。这项研究调查了针对青少年人群中BPD或边界特征而退出基于团体的基于心理的治疗（MBT-G）的原因。

方法：十名半结构化访谈对象是从基于小组的MBT进行BPD退学的女性青少年。使用系统文本压缩对数据进行定性分析。

结果：研究结果表明，存在一个青少年BPD患者亚组，他们对治疗没有足够的帮助或价值，他们对治疗的情感要求高，耗时且与不愉快的经历有关。据报病情好转的形式有提早终止的积极原因。辍学被理解为权衡感知收益与停留治疗的感知成本的过程。对辍学作为一个过程的这种理解意味着存在时间窗口，在该时间窗口中可以采取干预措施来防止辍学，这是对高危患者进行检测的先决条件。