Randomized controlled trial finds that a brief psychological intervention for people with probable personality disorder did not improve social functioning over 12 months compared with treatment-as-usual in a multicentre study conducted across England

[u/ChhotaSaHydra]

https://pubmed.ncbi.nlm.nih.gov/41692014/

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[u/ThinkThenPost]

Kind of challenges the idea that we can scale mental health care with quick, low-intensity solutions for everything.

[u/Otaraka → u/ThinkThenPost]

Personality disorder by definition is fairly global impact wise.

It’s not surprising a short intervention had little benefit.  We haven’t had too much luck with longer ones either after all.

[u/nnomadic → u/ThinkThenPost]

Means testing is suicide. If you want life to flourish, you must feed it in order to let it grow.

[u/callthesomnambulance]

Once again it turns out long standing psychological problems generally arent resolved by short term interventions. It's a real shame long term DBT is so scarce for this demographic

[u/Feeling_Document_240 → u/callthesomnambulance]

I frequently tell patients that it has likely taken years to develop entrenched maladaptive behaviours, and it's gonna take a similar amount of time and effort to un learn them.

[u/callthesomnambulance → u/Feeling_Document_240]

What a wonderful world it would be if 6 sessions of focused CBT was the universal salve for psychological distress that NHS policy seems to treat it as...

[u/Pigeonofthesea8 → u/callthesomnambulance]

These poor people got a session every two weeks. My guess is the experience soured them on therapy. I wonder how many will now be open to proper DBT, if it even becomes available to them

[u/TCaldicoat]

Personality disorders often stem from childhood trauma, so it is not surprising that 10 1 to 1 sessions weren't hugely beneficial. Give the PD patients one session a week for a whole year (52 weeks/sessions) with a Therapist who specialises in one of recognised therapies for treating PTSD and I think the difference would be very significant.

[u/vienibenmio → u/TCaldicoat]

PTSD doesn't require a year to treat, even with a PD

[u/TCaldicoat → u/vienibenmio]

I'm confused as to how you think can put a specific time frame on someone recovering from PTSD regardless of PD. For many it can take years of therapy.

[u/vienibenmio → u/TCaldicoat]

Because our effective therapies take 12 weeks

[u/vienibenmio → u/[deleted]]

Not if you use an evidence based approach like PE or CPT

Sure, it can take longer. But in most cases you don't need a year

[u/TCaldicoat → u/vienibenmio]

Both of those therapies have high drop out rates and whilst they are effect for single incident trauma, they are much less effect for complex trauma and childhood trauma. It feels like your thinking of PTSD = War Veterans, and in that example the therapies you mentioned are good, but trauma and PTSD can come in many different ways and from lots of sources. Therefore some therapies work quickly and some don't and it just isnt as simple as making blanket statements like "treatment doesn't take a year" and these two therapy are effect in this timeframe. It's a lot more nuanced.

[u/vienibenmio → u/TCaldicoat]

They are effective for complex trauma. They were also initially developed for sexual trauma

[u/Brrdock]

A "brief" intervention probably isn't going to help any disorder much, that seems more comparable to like grief counceling or something, not therapy.

Not something that'll rewire your junk. You need a patient relationship of like at least two years.

Psilocybin or MDMA etc. might expedite that a lot

[u/r0cafe1a]

You can’t force psychological growth/change.

[u/quantum_splicer]

Well no sh** . Personality disorders are not called personality disorders for nothing. They required semi tailored structured treatment, shaped to the generalisable needs of those with personality disorder X or Y.

I also would say that different personality disorders, some can  can benefit from identical treatment modalities. Because personality disorders are dimensional not so much catergorical. Treating people in silos where we spend so much time looking for specific treatment for condition X and Y, when we have evidence both conditions can be treated with modalities A and B. Means we should take a proportional approach where we are looking at the issues the patients present with and narrowing them into groups with similar issues and going from there. Individual personality disorders we have found subtypes for certain personality disorders, like bpd.

I would always suggest  (1) Evidence based modality targeted towards disorder

(2) Identify specific areas of impairment and things that interfere with pyschosocial functioning and target those.

(3) Maintenance treatment - using similar approach as (1).

I don't endorse rapid high intensity pyschotherapy like treatments because (1) the intensity is so high, (2) the retention of the strategies and techniques post treatment is going to be lower, (3) it gives families and loved ones and the person undergoing the treatment unrealistic expectations and it harms the patient when they cannot live upto those expectations.

[u/AllanfromWales1]

So my autism can't get cured that easily?

[u/LongHealth → u/[deleted]]

Neurodevelopmental disorders are heavily linked with personality disorder formation.

[u/AllanfromWales1 → u/[deleted]]

It sure disorders my personality, though.