Purpose

Nonspecific factors such as therapy alliance and treatment motivation have been shown to be predictive of therapy outcome. However, research investigating these factors among patients with personality disorders, or studies in the context of mandated treatment showed mixed results. A new theory furthermore speculates there may be differences between early formed therapeutic alliance (trait-like) versus alliance formed on the longer term (state-like). This paper aims to investigate the effects of therapy alliance and treatment motivation in 103 Dutch male forensic psychiatric patients with Cluster B personality disorders.

Design/methodology/approach

The authors used incidents as a measure of treatment outcome. They studied the effect of nonspecific factors on incidents in two phases, namely, 0 – 18 months and 18 – 36 months, along with known predictors of incidents (age, Historical items of the HCR-20 and psychopathy) as covariates.

Findings

Regression models predicting incidents in the first 18 months of treatment were nonsignificant. Incidents in the second 18 months were significantly predicted by models including alliance and motivation measured at the start of treatment, but not measures at 18 months and covariates. Predictors, except for age, were all nonsignificant.

Practical implications

These findings lend tentative support for the trait-like vs state-like theory of change through nonspecific factors. However, it may also be that other factors are more important in predicting therapy outcome in forensic psychiatric patients with Cluster B personality disorders.

Originality/value

The current study represents the first effort to study the effects of non-specific factors on therapeutic discourse in hospitalized offenders with Cluster B personality disorders.

中文翻译：

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B群人格障碍患者治疗联盟和治疗动机对法医医院事件的影响

目的

非特异性因素如治疗联盟和治疗动机已被证明可以预测治疗结果。然而，在人格障碍患者中调查这些因素的研究，或在强制治疗的背景下进行的研究显示出不同的结果。一种新理论进一步推测，早期形成的治疗联盟（类特质）与长期形成的联盟（类状态）之间可能存在差异。本文旨在研究治疗联盟和治疗动机对 103 名荷兰男性法医精神病患者的 B 类人格障碍的影响。

设计/方法/方法

作者使用事件作为治疗结果的衡量标准。他们研究了非特异性因素对两个阶段事件的影响，即 0 – 18 个月和 18 – 36 个月，以及已知的事件预测因子（年龄、HCR-20 的历史项目和精神病）作为协变量。

发现

预测治疗前 18 个月发生事件的回归模型不显着。后 18 个月的事件可通过包括治疗开始时测量的联盟和动机在内的模型进行显着预测，但不能在 18 个月时测量和协变量。除年龄外，预测因素均不显着。

实际影响

这些发现为通过非特定因素的类似特质与类似状态的变化理论提供了初步支持。然而，也可能是其他因素在预测患有 B 类人格障碍的法医精神病患者的治疗结果方面更为重要。

原创性/价值

目前的研究代表了第一次研究非特定因素对患有 B 类人格障碍的住院罪犯治疗话语的影响。