Comparing individual therapies for personality disordered opioid dependent patients

Area of Science:

• Psychiatry
• Psychology
• Addiction Medicine

Background:

• Personality disorders are common in patients receiving methadone maintenance.
• Effective psychotherapeutic interventions are needed for this population.

Purpose of the Study:

• To compare the efficacy of Dual Focus Schema Therapy (DFST) and 12 Step Facilitation Therapy (12FT) for outpatients with personality disorders on methadone maintenance.
• To evaluate treatment retention, utilization, symptom reduction, and therapeutic alliance.

Main Methods:

• Thirty personality disordered outpatients on methadone maintenance were randomized to 6-month manual-guided DFST or 12FT.
• Participants had diagnoses including antisocial, borderline, avoidant, and dependent personality disorders.
• Outcomes measured included retention, utilization, psychiatric symptoms, psychosocial impairment, substance use frequency, and therapeutic alliance.

Main Results:

• No significant differences were found between DFST and 12FT for retention, utilization, or reductions in psychiatric symptoms or psychosocial impairment.
• Both therapies led to significant reductions in various severity indicators.
• DFST showed more rapid decreases in substance use frequency and a stronger therapeutic alliance compared to 12FT.
• 12FT was associated with better reduction of dysphoric affect than DFST.

Conclusions:

• DFST demonstrates initial promise as a time-limited, manual-guided psychotherapy for personality disorders in substance abuse patients.
• DFST may offer advantages in reducing substance use and enhancing the therapeutic alliance.
• Further research is warranted to explore the specific benefits of each therapy for different patient outcomes.