Abstract
BackgroundThe aim of this study was to investigate whether therapeutic factors as identified by Yalom and potential additional therapeutic factors could be found in the qualitative individual reports of high-risk adolescents with personality disorders at the end of an intensive group psychotherapeutic MBT programme and whether the therapeutic factors were related to therapy outcomes.MethodsAt the end of treatment, 70 adolescents were asked to write a farewell letter. Content analysis of the letters was performed by two independent raters, using the 12 therapeutic factors of Yalom and potential additional therapeutic factors as coding categories. The factors were related to outcome, operationalized as a decrease in psychological symptoms as measured with the Symptom Check List 90 (SCL-90).ResultsAll therapeutic factors of Yalom and four new factors were identified in the letters, ranging from 1 to 97%. The factors of ‘cohesion’ (97%), ‘interpersonal learning output’ (94%), ‘guidance’ (98%) and ‘identification’ (94%) were found in most letters. By contrast, ‘universality’ (1%), ‘family re-enactment’ (3%) and ‘instillation of hope’ (1%) were found in very few letters. The factors ‘interpersonal learning input’, ‘self-esteem’ and ‘turning point’ were significantly associated with therapeutic recovery.ConclusionsLarge presence differences were encountered in therapeutic factors associated with resilience processes and the resolution of psychological distress. Although a relationship was found between certain factors and change in symptoms, it was unclear whether the factors had led to such change. Further research seems important for treatment in general and for the personalization of treatment.
Highlights
The aim of this study was to investigate whether therapeutic factors as identified by Yalom and potential additional therapeutic factors could be found in the qualitative individual reports of high-risk adolescents with personality disorders at the end of an intensive group psychotherapeutic mentalizationbased treatment (MBT) programme and whether the therapeutic factors were related to therapy outcomes
The aim of this study was to identify such therapeutic factors in ego narratives written without instruction by a high-risk adolescent sample after treatment for a personality disorder, and to relate these to changes in symptoms during treatment
As effective as individual therapy [7], it is argued that group psychotherapy, with its focus on peer relationships and identity formation, is preferable for Hauber et al Child Adolesc Psychiatry Ment Health (2019) 13:2 adolescents [8]
Summary
The aim of this study was to investigate whether therapeutic factors as identified by Yalom and potential additional therapeutic factors could be found in the qualitative individual reports of high-risk adolescents with personality disorders at the end of an intensive group psychotherapeutic MBT programme and whether the therapeutic factors were related to therapy outcomes. To provide an understanding of clients’ perceptions of the effectiveness of group psychotherapy in general, Corsini and Rosenberg [9] and later on Yalom [10] devised the concept of therapeutic factors The definitions of this concept vary, but typically the term refers to ‘curative factors’ or ‘mechanisms of change that occur through an intrinsic interplay of varied guided human experiences’ [11]. Yalom’s 12 therapeutic factors generated from his questionnaire were as follows: altruism, cohesion, universality, interpersonal learning input and output, guidance, catharsis, identification, family reenactment, self-understanding, instillation of hope, and existential factors They are widely accepted as corresponding to relevant and potent mechanisms that bring about changes through group psychotherapy
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