What the patient wants: Addressing patients' treatment targets in an integrative group psychotherapy programme

Psychol Psychother. 2019 Mar;92(1):20-38. doi: 10.1111/papt.12174. Epub 2018 Feb 13.

Abstract

Objectives: Limited empirical attention has been devoted to individualized treatment objectives in intensive group therapy for personality dysfunction. This study investigated patients' ratings of distress associated with individual therapy goals - referred to as target object severity - in an intensive Evening Treatment Programme for patients with personality dysfunction.

Design: Change in target objective severity was examined in a sample of 81 patients who completed treatment in an intensive, integrative group therapy programme.

Methods: Correlation and regression analyses were used to examine associations between change in target object severity and patients' pre-treatment diagnosis, symptom distress, and treatment outcome expectancy, and between change in target objective severity and patients' ratings of group therapy process (group climate, therapeutic alliance, group cohesion). The relationship between change in target objective severity and longer-range life satisfaction was also examined in a subsample of patients who rated life satisfaction at follow-up.

Results: While change in target objective severity was not significantly related to pre-treatment variables, significant associations were found with several aspects of group therapy process. Patients' experience of a highly engaged group climate was uniquely associated with improvement in target object severity. Such improvement was significantly related to longer-term life satisfaction after controlling for general symptom change.

Conclusion: The working atmosphere in group therapy contributes to patients' progress regarding individual treatment targets, and such progress is an important factor in later satisfaction. Attention to individualized treatment targets deserves further clinical and research attention in the context of integrative group therapy for personality dysfunction.

Practitioner points: This study found that patients attending an integrative group treatment programme for personality dysfunction experienced significant improvement in severity of distress related to individual treatment objectives. Improvement in severity of distress related to individual treatment objectives was uniquely associated with patients' experience of an engaged, collaborative working atmosphere. Improvement in individual target objective severity was associated with patients' ratings of overall life satisfaction, rated an average of 9 months following termination, after controlling for change in general symptom severity.

Keywords: group psychotherapy; individual treatment objectives; integrative treatment; personality dysfunction.

MeSH terms

  • Adult
  • Female
  • Humans
  • Interpersonal Relations
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Personality Disorders / therapy*
  • Psychotherapy / methods*
  • Psychotherapy, Group / methods*
  • Regression Analysis
  • Severity of Illness Index
  • Treatment Outcome