Effects of interventions promoting mentalization and interventions disconfirming pathogenic beliefs: A comparative single case study of three patients

• Published in: Cogent psychology 2018-12, Vol.5 (1), p.1470482
• Main Authors: Brockmann, Josef, Kirsch, Holger, Dembler, Katja, König, Dorothe, de Vries, Isolde, Zabolitzki, Monika, Silberschatz, George
• Format: Article
• Language: English
• Subjects: Borderline personality disorder; clinical ratings; Control Mastery Theory; experiencing; mentalization; Patients; reflective self-awareness; Self awareness; single case study; therapeutic alliance; therapeutic interventions; time series analysis
• ISSN: 2331-1908; 2331-1908
• DOI: 10.1080/23311908.2018.1470482

Design: The effects of two types of interventions were investigated in an explorative single-case study of three patients with chronic depression and/or borderline personality disorder over 20 therapy sessions (sessions 2-11 and sessions 51-60). The ratings of therapeutic interventions that promoted mentalization were based on the concept of mentalization (Bateman & Fonagy), and the ratings of those disconfirming pathogenic beliefs were based on Control Mastery Theory (Weiss & Sampson). The effect of therapeutic interventions (mentalization vs. pathogenic beliefs) was assessed by measuring the level of reflective self-awareness, which was rated using the Experiencing Scale. The therapeutic alliance relationship was examined each session by a questionnaire. Therapy sessions were analysed with two different time series analyses. Each session was rated in five-minute sections. Results: In the time-series analysis, therapeutic interventions promoting mentalization and those disconfirming pathogenic beliefs correlated significantly with reflective self-awareness for two of the three patients. For one patient, there was no correlation. However, the results in the trend were different. For all patients, reflective self-awareness decreased or remained stable, and therapeutic alliance improved. This needs to be explained. Conclusions: The significant association between therapeutic interventions and patients' reflective self-awareness can be understood as a reciprocal causal process that is co-created by the patient and the therapist. The deviating results, especially for the third patient, are discussed.