Metacognitive Interpersonal Group Therapy for Adolescents With Emerging Personality Disorders: The Case of Nora

An increasing number of adolescents attending child and adolescent mental health services present symptoms consistent with an emerging personality disorder (PD). Early identification and intervention are critical to preventing the devastating progression of symptoms, reducing the duration of untreated disorders, and supporting the recovery, development, and future quality of life of these individuals. The primary aim of this paper is to introduce a group therapy proposal designed for the entire spectrum of adolescent PDs: Metacognitive Interpersonal Group Therapy for Adolescents (MIT-GA). MIT-GA is a profoundly experiential interpersonal psychotherapy aimed at promoting the progressive growth of awareness and regulation of mental states, that is metacognition, and so alleviating symptoms and interpersonal problems. The paper first outlines the core principles of the treatment, its general structure, and session content. Next, it illustrates the therapeutic methodology through the case of Nora, a 16-year-old adolescent suffering from emerging, moderate PD with mixed features, primarily dependent and borderline. To evaluate the therapy's impact, quantitative and qualitative results are presented before and after the treatment, as well as 6 months post-therapy, focusing on symptomatology, interpersonal functioning, and overall functioning. Finally, the paper offers reflections on working with PDs, and discusses the advantages and challenges of MIT-GA.