Preliminary relationships between adherence and outcome in dynamic deconstructive psychotherapy.

Area of Science:

• Psychiatry
• Psychology
• Clinical Psychology

Background:

• Borderline personality disorder (BPD) and alcohol use disorders often co-occur.
• Treatment-resistant clients with BPD require specialized therapeutic approaches.
• Dynamic deconstructive psychotherapy (DDP) is a novel psychodynamic therapy designed for complex cases.

Purpose of the Study:

• To investigate the relationship between adherence to DDP techniques and treatment outcomes.
• To assess the efficacy of DDP in clients with comorbid BPD and alcohol use disorders.
• To evaluate the psychometric properties of a novel adherence rating scale for DDP.

Main Methods:

• A sample of 10 clients with dual diagnoses of BPD and alcohol use disorders received 12 months of DDP.
• Videotaped sessions were rated by independent coders for adherence to DDP techniques, therapeutic alliance, and other therapeutic modalities.
• A newly developed scale was used to measure adherence to DDP, demonstrating excellent reliability.

Main Results:

• Adherence to DDP techniques showed a significant positive correlation with improvements in BPD symptoms (ρ = .64).
• Higher adherence was also associated with positive changes in most secondary outcome measures.
• The DDP adherence instrument exhibited strong interrater and test-retest reliability.

Conclusions:

• Adherence to specific DDP techniques is a significant predictor of positive treatment outcomes in individuals with BPD.
• DDP appears to be a promising therapeutic approach for treatment-resistant clients with comorbid BPD and alcohol use disorders.
• The developed adherence scale is a reliable tool for assessing fidelity in DDP.