Adam Polnay1, Claire MacLean2, Emma Lewington3, Jon Patrick4. 1. Specialty Registrar in Psychotherapy, Edinburgh Psychotherapy Department, Royal Edinburgh Hospital, Edinburgh, UK; Honorary Fellow, Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK adam.polnay@nhs.net. 2. Clinical Psychologist, Edinburgh Psychotherapy Department, Royal Edinburgh Hospital, Edinburgh, UK. 3. Specialty Doctor in Psychotherapy, Edinburgh Psychotherapy Department, Royal Edinburgh Hospital, Edinburgh, UK. 4. Consultant Psychiatrist in Psychotherapy, Edinburgh Psychotherapy Department, Royal Edinburgh Hospital, Edinburgh, UK.
Abstract
BACKGROUND AND AIMS: Negative attitudes in clinicians towards people with personality disorder are common and associated with poor care. National guidelines recommend developing interventions to improve attitudes. Mentalization-based treatment theory and techniques provide a plausible intervention. We therefore evaluated the effect of teaching mentalizing skills on clinicians' attitudes towards personality disorder. METHODS: Pilot before-and-after study of trainee psychiatrists receiving four teaching sessions in mentalizing skills. Self-report questionnaires were completed at baseline and post teaching programme. MAIN OUTCOME MEASURE: Attitudes to Personality Disorder Questionnaire. SECONDARY MEASURE: Knowledge and Application of Mentalization-based treatment Questionnaire. RESULTS: Sixteen doctors were recruited with no study drop-out. Mean Attitudes to Personality Disorder Questionnaire score was superior post teaching programme versus baseline (135.3 vs. 124.5, standardised mean difference = 0.72, 95% confidence interval = 0.01 to 1.44). Mean Knowledge and Application of Mentalization-based treatment Questionnaire score was superior post teaching programme versus baseline (112.5 vs. 97.1, standardised mean difference = 1.83, 95% confidence interval 0.98 to 2.67). CONCLUSIONS: As expected from a pilot study, the estimate of effect is imprecise. Within this limitation, our findings suggest that teaching in mentalizing skills improved attitudes and mentalization-based treatment knowledge to a clinically relevant degree. This has important implications for patient outcomes and staff development. Our study paves the way for a full-scale study to provide more precise and robust evidence.
BACKGROUND AND AIMS: Negative attitudes in clinicians towards people with personality disorder are common and associated with poor care. National guidelines recommend developing interventions to improve attitudes. Mentalization-based treatment theory and techniques provide a plausible intervention. We therefore evaluated the effect of teaching mentalizing skills on clinicians' attitudes towards personality disorder. METHODS: Pilot before-and-after study of trainee psychiatrists receiving four teaching sessions in mentalizing skills. Self-report questionnaires were completed at baseline and post teaching programme. MAIN OUTCOME MEASURE: Attitudes to Personality Disorder Questionnaire. SECONDARY MEASURE: Knowledge and Application of Mentalization-based treatment Questionnaire. RESULTS: Sixteen doctors were recruited with no study drop-out. Mean Attitudes to Personality Disorder Questionnaire score was superior post teaching programme versus baseline (135.3 vs. 124.5, standardised mean difference = 0.72, 95% confidence interval = 0.01 to 1.44). Mean Knowledge and Application of Mentalization-based treatment Questionnaire score was superior post teaching programme versus baseline (112.5 vs. 97.1, standardised mean difference = 1.83, 95% confidence interval 0.98 to 2.67). CONCLUSIONS: As expected from a pilot study, the estimate of effect is imprecise. Within this limitation, our findings suggest that teaching in mentalizing skills improved attitudes and mentalization-based treatment knowledge to a clinically relevant degree. This has important implications for patient outcomes and staff development. Our study paves the way for a full-scale study to provide more precise and robust evidence.
Authors: Adam Polnay; Lindsey G McIntosh; Aileen Burnett; Andrea Williams; Catherine Cahill; Peter Wilkinson; Fiona Mohammad; Jon Patrick Journal: Health Sci Rep Date: 2021-02-15