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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