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OverviewofresearchlinesatDe
Viersprong
JoostHutsebaut,DawnBalesetalMBT-mee?ngVienna2016
Thebeginning
• 2004:startofDHMBT-programatdeViersprong
– Replica?onoforiginalAFC-program
– Excellentoutcomes:• Bales,D.,Beek,N.van,Smits,M.,Willemsen,S.,Busschbach,J.J.V.,Verheul,R.,&
Andrea,H.(2012)Treatmentoutcomeof18-month,dayhospitalmentaliza?on-basedtreatment(MBT)inpa?entswithsevereborderlinepersonalityintheNetherland.JournalofPersonalityDisorders,26,568-582.
• Bales,D.L.,Timman,R.,Andrea,H.,Busschbach,J.J.V.,Verheul,R.,&Kamphuis,J.H.(2015).Effec?venessofday-hospitalMentaliza?on-basedTreatmentforpa?entswithsevereborderlinePersonalitydisorder:amatchedcontrolstudy.ClinicalPsychology&Psychotherapy,22,409-417.
Growing…
Newchallenges:treatmentassignmentChallenge1:MBT-DHisexpensive
2008:introduc?onMBT-IOPatdeViersprong2012:ini?a?onMBT-DOS
Incollabora?onwithLen?sandArkinFundedbyZonMWPhDresearchMaaikeSmits
ComparisonofMBT-DHandMBT-IOPintermsof(cost)effec?vityTreatmentassignment:whoneedswhatdosageoftreatment?Laurenssen,E.M.P.,Smits,M.L.,Bales,D.L.,Feenstra,D.J.,Eeren,H.V.,Noom,M.J.,Köster,M.A.,Lucas,Z.,Timman,R.,Dekker,J.J.M.,Luyten,P.,Busschbach,J.J.V.,&Verheul,R.(2014).DayhospitalMentaliza?on-basedTreatmentversusintensiveoutpa?entMentaliza?on-basedTreatmentforpa?entswithsevereborderlinePersonalitydisorder:protocolofamul?centrerandomizedclinicaltrial.BMCPsychiatry,14,301.
Newchallenges:implementa?onChallenge2:Implementa?onmafers
Newchallenges
• Implementa?onmafers:– Theeffec?venessofMBTdropsdrama?callyinperiodsofreorganiza?on• Bales,Timman,Luyten,Busschbach,Verheul&Hutsebaut:Implementa?onof
Evidence-BasedTreatmentsforBorderlinePersonalityDisorder:TheImpactofOrganiza?onalChangesonTreatmentOutcomeofMentaliza?on-BasedTreatment(submifed)
– Implementa?onofMBThasogenbeencumbersomeintheNetherlands• Bales,Verheul&Hutsebaut:Determinantsofsuccessandfailureinthe
implementa?onofMentaliza?on-BasedTreatment(MBT)forsevereborderlinepersonalitydisorder:anexplora?vemul?plecasestudy(submifed)
Newchallenges:implementa?onandqualitymonitoring
• Theissuebecomes:howcananMBT-programbeimplementedinasafeandeffec?vewayandhowcanthequalitybemaintainedwhiletheprogramisrunning?– PhDDawnBales
• Qualitymanual:– BatemanA,BalesD,HutsebautJ.AQualityManualforMBT2013
• Qualitysystem– RCTMBT‘regular’versusMBT‘supportedbyQS’
TowardaQualitySystemforMBT
Organiza?on Supervisor Expert
Team Pa?ent
Team
Treatmentmanual
QualityManual
TherapistandTeamAdherenceandCompetenceScale
Auditoftheprogram
Newchallenges:youngpeople
Challenge3:BPDdoesnotonlyaffectadults2008:inpa?entMBT-ALaurenssen,E.M.P.,Hutsebaut,J.,Feenstra,D.J.,Busschbach,J.J.V.,Noom,M.J.,Bales,D.L.,Luyten,P.,&Verheul,R.(2013).FeasibilityofMentaliza?on-basedTreatmentforadolescentswithborderlinesymptoms:Apilotstudy.Psychotherapy
2010-present:MBT-AIOP
Combina?onofindividual,groupandfamilytherapyforYP(16+)withfullBPD,basedupontheIOPformatRemeeus,Feenstraetal(inprep).Effec?venessofanIntensiveOutpa?entMBTprogramforadolescents.
Newchallenges
2014-present:MBT-early‘Earlyinterven?on/indicatedpreven?onprogram’forYP(12+)with
featuresofBPDorrecentlydevelopedfullBPD,largelyinspiredbyAndrewChanen’sHYPE-CATprogramThechallengeisthreefold:• DesigningastagingmodelforBPDasaheuris?cschemefortreatmentassignment(whatkind/dosageoftreatmentforwhichstageofBPD?)• Determiningriskandprotec?vefactorsthatinfluence‘diseaseprogression’anddesign/adjustinterven?onstotacklethese• Design/inves?gateeasyaccessibleandcost-effec?veinterven?onstohelpabroadrangeofvulnerableYP
Addi?onalprojects
• MBT-P:preven?onprogramformothers(withBPD)– PhDLiesbetNijssens
• MBT-iforparents/adolescents:psycho-educa?onalcourseforadolescentsandtheirparents