Developing stage-tailored interventions to prevent and intervene early in young people with a disposition to develop borderline personality disorder

 

Submission type

Symposium

Scheduled

Parallel Session III: Mendes da Costa kamer, 08-06-2018, 13:00 - 14:30

Kernwoorden

Early intervention, Borderline, Adolescents, MBT

Onderzoeksgebied

Child & adolescent

Beknopte samenvatting van de totale bijdrage

The symposium will present a model of clinical staging and health management for Borderline PD and discuss a range of stage-tailored interventions (MBT-early and MBT-A) for young people with emerging BPD based upon Mentalization-Based Treatment. It argues that BPD should be treated in different dosages according to its progress.

Auteurs

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Hutsebaut, J (Joost)

 

Abstract ID

1149

Submission type

Oral only

Introductie

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Materiaal en methodes

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Resultaten

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Conclusie

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Auteurs

A life span perspective on Borderline personality disorder: clinical staging and health management

Hutsebaut, J (Joost)

 

Abstract ID

1124

Submission type

Oral only

Introductie

Borderline personality disorder (BPD) is a potentially devastating mental disorder, which can result in a high burden of disease, high care consumption and reduced life expectancy. BPD develops from early childhood on and manifests itself from puberty. There is evidence that early stages of BPD can be detected reliably and treated safely, while inadequate or late onset of treatment might be associated with progression of the disorder and subsequent disability and distress in adulthood.

Materiaal en methodes

These findings lay the foundation for an approach of BPD from the perspective of health management, underpinned by a model of clinical staging and a life span perspective

Resultaten

Based upon an extensive review of literature on BPD throughout the lifespan, a model of clinical staging for BPD will be presented. This model discusses the phenomenological expressions of BPD in different stages of the disorder. It will be argued that treatment should be organized according to these different stages. A model of Health management for BPD will be introduced, relating different interventions to the stages of BPD.

Conclusie

We conclude that the treatment of BPD should focus less on intensive treatment of severely progressed cases of the disorder and instead should move towards prevention and early intervention.

Auteurs

MBT-early: an early intervention program for young people with emerging borderline personality disorder

Feenstra, D.J. (Dineke)

 

Abstract ID

1127

Submission type

Oral only

Introductie

Mentalization-based Treatment (MBT) is an evidence based treatment for Borderline Personality Disorder (BPD) which has been demonstrated to be effective for adolescents with (traits of) BPD. BPD usually emerges during adolescence and is highly predictive for severe and chronic developmental arrest and a range of unfavorable outcomes beyond adolescence. An important aim of early intervention programs for BPD is to detect the development of BPD in an early stage and provide effective treatment in order to prevent or reduce these outcomes

Materiaal en methodes

This presentation will discuss the aims and format of the MBT-early program and provide some preliminary routine outcome monitoring data to support its feasibility.

Resultaten

MBT-early is an adaptation of MBT that aims to provide specialist treatment for (young) adolescents in an early stage of BPD. It is a well-structured, manualized treatment program, integrating psychotherapy, family sessions, farmacotherapy and case management in order to support a healthy developmental pathway for young adolescents with emerging BPD. This presentation will focus upon clinical experiences with treatment assignment, intermittent therapy and integrated treatment. Preliminary routine outcome monitoring data are promising.

Conclusie

Early intervention is feasible, although long term outcomes are still unknown. More research is needed to demonstrate cost-effectiveness of early intervention programs.

Auteurs

MBT-A: an intensive outpatient program for young people with severe borderline personality disorder

Bales, D.L. (Dawn)

 

Abstract ID

1128

Submission type

Oral only

Introductie

BPD in adolescence is highly predictive for a range of invalidating consequences in adulthood, most notably adult BPD, and should therefore be treated appropriately before its course can become chronic. The effectiveness of MBT in adolescents has been demonstrated in previous studies, supporting its feasibility as a treatment approach for young people with Borderline PD.

Materiaal en methodes

This presentation will discuss the aims and format of the MBT-A program and provide some preliminary routine outcome monitoring data to support its feasibility

Resultaten

As compared to MBT-early, MBT-A is focused upon young people with very severe BPD, impacting largely upon their social and school life. MBT-A provides a manualized treatment integrating intensive individual, group and family therapy with case management, psychiatric review and crisis management. The treatment trajectory is divided in a pre-treatment, main treatment and post-treatment phase, each characterized by its own treatment goals and modalities. Committing young people and their families to treatment and managing disruptive emotional outbursts are at the centre of the treatment. This presentation will focus upon the major challenges in treating this difficult patient group. Routine outcome monitoring data are promising.

Conclusie

Although adolescents with BPD may be among the most challenging patients, treatment is feasible and effective.

Auteurs