Adjunctive avatar therapy for mentalization based treatment of borderline personality disorder: a mixed methods feasibility study

Background: Borderline personality disorder (BPD) is characterized by severe instability in emotions, identity, relationships, and impulsive behaviour. One contributing factor to BPD is deficient mentalizing - our ability to understand the mental states of others and ourselves. Psychotherapies can b...

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Main Authors: Falconer, Caroline J., Cutting, Penny, Davies, Eleanor Bethan, Hollis, Chris, Stallard, Paul, Moran, Paul
Format: Article
Published: BMJ Publishing Group 2017
Online Access:https://eprints.nottingham.ac.uk/48621/
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author Falconer, Caroline J.
Cutting, Penny
Davies, Eleanor Bethan
Hollis, Chris
Stallard, Paul
Moran, Paul
author_facet Falconer, Caroline J.
Cutting, Penny
Davies, Eleanor Bethan
Hollis, Chris
Stallard, Paul
Moran, Paul
author_sort Falconer, Caroline J.
building Nottingham Research Data Repository
collection Online Access
description Background: Borderline personality disorder (BPD) is characterized by severe instability in emotions, identity, relationships, and impulsive behaviour. One contributing factor to BPD is deficient mentalizing - our ability to understand the mental states of others and ourselves. Psychotherapies can be effective at reducing symptoms of BPD but effects are small. Innovative ways of enhancing existing therapies are therefore essential. Objectives: In a mixed-methods, feasibility and acceptability study we adjuncted conventional mentalization based treatment (MBT) for BPD with avatar software (avatar-MBT). We wanted to test whether the enhanced visual narrative afforded by the software would facilitate therapy. Methods: We used proprietary avatar software in four group MBT sessions. We collected data on up-take (n=15), drop-out (n=4), and self-report measures (n=11) of mentalization and mood, and conducted qualitative interviews to assess attitudes and beliefs (n=9). Findings: Thematic analysis revealed five themes on the usefulness of avatar-MBT, including facilitating perspective taking, expression, emotional distancing, the big picture, and group participation. The sixth theme suggested avatar-MBT is best placed within a group setting. There was no deterioration in symptoms as monitored by self-report measures. Conclusions: Qualitative data suggests that avatar-MBT is acceptable to patients with BPD who described it as enhancing conventional MBT and expressed a wish to continue using it. However, controlled trials are required to assess efficacy. Clinical Implications: Results suggest that avatar-MBT may be a viable option to enhance existing BPD treatment. Furthermore, we provide initial evidence that it is feasible to implement a digital adjunct within a group therapy setting.
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spelling nottingham-486212020-05-04T19:13:47Z https://eprints.nottingham.ac.uk/48621/ Adjunctive avatar therapy for mentalization based treatment of borderline personality disorder: a mixed methods feasibility study Falconer, Caroline J. Cutting, Penny Davies, Eleanor Bethan Hollis, Chris Stallard, Paul Moran, Paul Background: Borderline personality disorder (BPD) is characterized by severe instability in emotions, identity, relationships, and impulsive behaviour. One contributing factor to BPD is deficient mentalizing - our ability to understand the mental states of others and ourselves. Psychotherapies can be effective at reducing symptoms of BPD but effects are small. Innovative ways of enhancing existing therapies are therefore essential. Objectives: In a mixed-methods, feasibility and acceptability study we adjuncted conventional mentalization based treatment (MBT) for BPD with avatar software (avatar-MBT). We wanted to test whether the enhanced visual narrative afforded by the software would facilitate therapy. Methods: We used proprietary avatar software in four group MBT sessions. We collected data on up-take (n=15), drop-out (n=4), and self-report measures (n=11) of mentalization and mood, and conducted qualitative interviews to assess attitudes and beliefs (n=9). Findings: Thematic analysis revealed five themes on the usefulness of avatar-MBT, including facilitating perspective taking, expression, emotional distancing, the big picture, and group participation. The sixth theme suggested avatar-MBT is best placed within a group setting. There was no deterioration in symptoms as monitored by self-report measures. Conclusions: Qualitative data suggests that avatar-MBT is acceptable to patients with BPD who described it as enhancing conventional MBT and expressed a wish to continue using it. However, controlled trials are required to assess efficacy. Clinical Implications: Results suggest that avatar-MBT may be a viable option to enhance existing BPD treatment. Furthermore, we provide initial evidence that it is feasible to implement a digital adjunct within a group therapy setting. BMJ Publishing Group 2017-10-22 Article PeerReviewed Falconer, Caroline J., Cutting, Penny, Davies, Eleanor Bethan, Hollis, Chris, Stallard, Paul and Moran, Paul (2017) Adjunctive avatar therapy for mentalization based treatment of borderline personality disorder: a mixed methods feasibility study. Evidence-Based Mental Health, 20 (4). pp. 123-127. ISSN 1468-960X http://ebmh.bmj.com/content/20/4/123 doi:10.1136/eb-2017-102761 doi:10.1136/eb-2017-102761
spellingShingle Falconer, Caroline J.
Cutting, Penny
Davies, Eleanor Bethan
Hollis, Chris
Stallard, Paul
Moran, Paul
Adjunctive avatar therapy for mentalization based treatment of borderline personality disorder: a mixed methods feasibility study
title Adjunctive avatar therapy for mentalization based treatment of borderline personality disorder: a mixed methods feasibility study
title_full Adjunctive avatar therapy for mentalization based treatment of borderline personality disorder: a mixed methods feasibility study
title_fullStr Adjunctive avatar therapy for mentalization based treatment of borderline personality disorder: a mixed methods feasibility study
title_full_unstemmed Adjunctive avatar therapy for mentalization based treatment of borderline personality disorder: a mixed methods feasibility study
title_short Adjunctive avatar therapy for mentalization based treatment of borderline personality disorder: a mixed methods feasibility study
title_sort adjunctive avatar therapy for mentalization based treatment of borderline personality disorder: a mixed methods feasibility study
url https://eprints.nottingham.ac.uk/48621/
https://eprints.nottingham.ac.uk/48621/
https://eprints.nottingham.ac.uk/48621/