Change mechanisms of schema-centered group psychotherapy with personality disorder patients

Tschacher, Wolfgang; Zorn, Peter; Ramseyer, Fabian (2012). Change mechanisms of schema-centered group psychotherapy with personality disorder patients. PLoS ONE, 7(6), e39687. Lawrence, Kans.: Public Library of Science 10.1371/journal.pone.0039687

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Background

This study addressed the temporal properties of personality disorders and their treatment by schema-centered group psychotherapy. It investigated the change mechanisms of psychotherapy using a novel method by which psychotherapy can be modeled explicitly in the temporal domain.
Methodology and Findings

69 patients were assigned to a specific schema-centered behavioral group psychotherapy, 26 to social skills training as a control condition. The largest diagnostic subgroups were narcissistic and borderline personality disorder. Both treatments offered 30 group sessions of 100 min duration each, at a frequency of two sessions per week. Therapy process was described by components resulting from principal component analysis of patients' session-reports that were obtained after each session. These patient-assessed components were Clarification, Bond, Rejection, and Emotional Activation. The statistical approach focused on time-lagged associations of components using time-series panel analysis. This method provided a detailed quantitative representation of therapy process. It was found that Clarification played a core role in schema-centered psychotherapy, reducing rejection and regulating the emotion of patients. This was also a change mechanism linked to therapy outcome.
Conclusions/Significance

The introduced process-oriented methodology allowed to highlight the mechanisms by which psychotherapeutic treatment became effective. Additionally, process models depicted the actual patterns that differentiated specific diagnostic subgroups. Time-series analysis explores Granger causality, a non-experimental approximation of causality based on temporal sequences. This methodology, resting upon naturalistic data, can explicate mechanisms of action in psychotherapy research and illustrate the temporal patterns underlying personality disorders.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Psychotherapy
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Management

UniBE Contributor:

Tschacher, Wolfgang; Zorn, Peter and Ramseyer, Fabian

ISSN:

1932-6203

Publisher:

Public Library of Science

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:39

Last Modified:

10 Dec 2014 19:34

Publisher DOI:

10.1371/journal.pone.0039687

PubMed ID:

22745811

Web of Science ID:

000305730900098

BORIS DOI:

10.7892/boris.15811

URI:

https://boris.unibe.ch/id/eprint/15811 (FactScience: 223268)

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