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A pilot before-and-after study of a brief teaching programme for psychiatry trainees in mentalizing skills
Adam Polnay1, Claire MacLean2, Emma Lewington3
1Specialty Registrar in Psychotherapy, Edinburgh Psychotherapy Department, Royal Edinburgh Hospital, Edinburgh, UK; Honorary Fellow, Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK adam.polnay@nhs.net.
Background And Aims:
Negative attitudes in clinicians towards people with personality disorder are common and associated with poor care. National guidelines recommend developing interventions to improve attitudes. Mentalization-based treatment theory and techniques provide a plausible intervention. We therefore evaluated the effect of teaching mentalizing skills on clinicians' attitudes towards personality disorder.
Methods:
Pilot before-and-after study of trainee psychiatrists receiving four teaching sessions in mentalizing skills. Self-report questionnaires were completed at baseline and post teaching programme.
Main Outcome Measure:
Attitudes to Personality Disorder Questionnaire.
Secondary Measure:
Knowledge and Application of Mentalization-based treatment Questionnaire.
Results:
Sixteen doctors were recruited with no study drop-out. Mean Attitudes to Personality Disorder Questionnaire score was superior post teaching programme versus baseline (135.3 vs. 124.5, standardised mean difference = 0.72, 95% confidence interval = 0.01 to 1.44). Mean Knowledge and Application of Mentalization-based treatment Questionnaire score was superior post teaching programme versus baseline (112.5 vs. 97.1, standardised mean difference = 1.83, 95% confidence interval 0.98 to 2.67).
Conclusions:
As expected from a pilot study, the estimate of effect is imprecise. Within this limitation, our findings suggest that teaching in mentalizing skills improved attitudes and mentalization-based treatment knowledge to a clinically relevant degree. This has important implications for patient outcomes and staff development. Our study paves the way for a full-scale study to provide more precise and robust evidence.
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