Monteregge, Sabrina;
(2024)
The Role of Initial Levels of Epistemic Trust in Mentalization-Based Psychoeducation
Interventions for Borderline Personality Disorder.
Doctoral thesis (D.Clin.Psy), UCL (University College London).
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Abstract
Aims. Psychological therapies for borderline personality disorder (BPD) emphasise the development and maintenance of a collaborative relationship between patient and therapist. The therapeutic alliance has been shown to predict outcomes across psychotherapies, however, the relationship between alliance and outcome in psychological therapies for BPD has not been thoroughly reviewed. Methods. This systematic review and meta-analysis searched PsycINFO, MEDLINE, Embase, Web of Science, and CINAHL plus for controlled and observational studies reporting on the relationship between alliance and outcomes of psychological treatments for adults with BPD. Primary outcomes included BPD symptom severity, suicidality, and dropout, and secondary outcomes were other mental health symptoms and interpersonal functioning. Data were synthesised narratively and using meta-analyses. Study quality was assessed using the National Health Institutes of Health Quality Assessment Tool and the study is registered with PROSPERO (CRD42023464020). Results. Searches identified 1924 records, of which we included 24 studies, representing 18 independent samples with a total of 1753 patients. There were small numbers of studies reporting on each alliance-outcome association. Meta-analyses found a small association between alliance and BPD severity and mental health symptoms and a very small association between alliance and dropout. The strongest evidence in large, adequately powered studies found higher quality alliance is associated with improvement in secondary mental health symptoms, interpersonal functioning and self-harm. Conclusion. This review emphasised the need for larger, more rigorous studies to disentangle the alliance-outcome relationship in BPD psychological treatments. Current evidence is limited by significant variation and insufficiently powered studies. Advances in statistical methods could be used to model within- and between-variability to better capture alliance as dynamic construct.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | D.Clin.Psy |
| Title: | The Role of Initial Levels of Epistemic Trust in Mentalization-Based Psychoeducation Interventions for Borderline Personality Disorder |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2024. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10198314 |
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