Brief psychoeducation for people with personality disorder: A pilot study

Abstract

Background. The Patients' Charter for Mental Health Services (DON, 1997) states that a patient is entitled to both know and understand his or her diagnosis. Despite this, personality disordered clients are not always well informed about their disorder. Some will not be told their diagnosis because of concern that to do so would damage the therapeutic alliance. Objective. To test the hypothesis that the therapeutic alliance is not compromised by engaging in a psychoeducation programme that informs about personality disorder. Design. Pilot study, pre-post design. Methods. Eighteen forensic in-patients and 16 community out-patients separately participated in a 4-session individual programme that focused on personality, personality disorder, and their own diagnosis. Understanding of these concepts was explored in a brief structured interview. Therapeutic alliance was assessed pre- and post-intervention using the Agnew relationship measure. Results. For both samples, participation in the intervention resulted in a positive change in four of the five measured components of the therapeutic alliance. This change was rated more strongly by clients than therapists, and reached statistical significance for bond, partnership, and confidence subscales. Participants demonstrated improved knowledge of their disorder following the intervention, and all but one gave positive feedback. Conclusion. These findings support the hypothesis and suggest the therapeutic relationship is not impaired when a diagnosis of personality disorder is imparted using this psychoeducation programme.