Overview of research lines at De Viersprong. Joost Hutsebaut, Dawn Bales et al MBT-mee?ng Vienna 2016

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1 Overview of research lines at De Viersprong Joost Hutsebaut, Dawn Bales et al MBT-mee?ng Vienna 2016

2 The beginning 2004: start of DH MBT-program at de Viersprong Replica?on of original AFC-program Excellent outcomes: Bales, D., Beek, N. van, Smits, M., Willemsen, S., Busschbach, J.J.V., Verheul, R., & Andrea, H. (2012) Treatment outcome of 18-month, day hospital mentaliza?onbased treatment (MBT) in pa?ents with severe borderline personality in the Netherland. Journal of Personality Disorders, 26, Bales, D.L., Timman, R., Andrea, H., Busschbach, J.J.V., Verheul, R., & Kamphuis, J.H. (2015). Effec?veness of day-hospital Mentaliza?on-based Treatment for pa?ents with severe borderline Personality disorder: a matched control study. Clinical Psychology & Psychotherapy, 22,

3 Growing

4 New challenges: treatment assignment Challenge 1: MBT-DH is expensive 2008: introduc?on MBT-IOP at de Viersprong 2012: ini?a?on MBT-DOS In collabora?on with Len?s and Arkin Funded by ZonMW PhD research Maaike Smits Comparison of MBT-DH and MBT-IOP in terms of (cost)effec?vity Treatment assignment: who needs what dosage of treatment? 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). Day hospital Mentaliza?onbased Treatment versus intensive outpa?ent Mentaliza?on-based Treatment for pa?ents with severe borderline Personality disorder: protocol of a mul?centre randomized clinical trial. BMC Psychiatry, 14, 301.

5 New challenges: implementa?on Challenge 2: Implementa?on mafers

6 New challenges Implementa?on mafers: The effec?veness of MBT drops drama?cally in periods of reorganiza?on Bales, Timman, Luyten, Busschbach, Verheul & Hutsebaut: Implementa?on of Evidence-Based Treatments for Borderline Personality Disorder: The Impact of Organiza?onal Changes on Treatment Outcome of Mentaliza?on-Based Treatment (submifed) Implementa?on of MBT has ogen been cumbersome in the Netherlands Bales, Verheul & Hutsebaut: Determinants of success and failure in the implementa?on of Mentaliza?on-Based Treatment (MBT) for severe borderline personality disorder: an explora?ve mul?ple case study (submifed)

7 New challenges: implementa?on and quality monitoring The issue becomes: how can an MBT-program be implemented in a safe and effec?ve way and how can the quality be maintained while the program is running? PhD Dawn Bales Quality manual: Bateman A, Bales D, Hutsebaut J. A Quality Manual for MBT2013 Quality system RCT MBT regular versus MBT supported by QS

8 Toward a Quality System for MBT Organiza?on Supervisor Expert Team Pa?ent Team Quality Manual Treatment manual Therapist and Team Adherence and Competence Scale Audit of the program

9 New challenges: young people Challenge 3: BPD does not only affect adults 2008: inpa?ent MBT-A Laurenssen, E.M.P., Hutsebaut, J., Feenstra, D.J., Busschbach, J.J.V., Noom, M.J., Bales, D.L., Luyten, P., & Verheul, R. (2013). Feasibility of Mentaliza?on-based Treatment for adolescents with borderline symptoms: A pilot study. Psychotherapy 2010-present: MBT-A IOP Combina?on of individual, group and family therapy for YP (16+) with full BPD, based upon the IOP format Remeeus, Feenstra et al (in prep). Effec?veness of an Intensive Outpa?ent MBT program for adolescents.

10 New challenges 2014-present: MBT-early Early interven?on / indicated preven?on program for YP (12+) with features of BPD or recently developed full BPD, largely inspired by Andrew Chanen s HYPE-CAT program The challenge is threefold: Designing a staging model for BPD as a heuris?c scheme for treatment assignment (what kind/dosage of treatment for which stage of BPD?) Determining risk and protec?ve factors that influence disease progression and design/adjust interven?ons to tackle these Design/inves?gate easy accessible and cost-effec?ve interven?ons to help a broad range of vulnerable YP

11 Addi?onal projects MBT-P: preven?on program for mothers (with BPD) PhD Liesbet Nijssens MBT-i for parents/adolescents: psycho-educa?onal course for adolescents and their parents