Comparing Generalist and Specialist Psychotherapy Treatments for Severe Personality Disorders A Randomized Study

What this Trial Is About

Researchers are evaluating whether generalist treatment GIT-PD is not less effective than specialist treatments like Mentalization-Based Treatment MBT or Schema Therapy ST in improving the level of personality functioning in adults with severe personality disorders. The study also aims to find out which patient characteristics predict better responses to either specialist or generalist treatment. This pragmatic randomized controlled trial compares these approaches to help understand treatment options for severe personality disorders. Participants will be randomly assigned to receive either specialist treatmentMBT or ST, depending on availability and patient needsor generalist treatment following the Guideline-Informed Treatment for Personality Disorders GIT-PD. Specialist treatments require a minimum of 40 sessions or 12 to 24 months duration, while GIT-PD is a flexible, principle-driven approach lasting 12 to 18 months with assessment, modular treatment, and relapse prevention phases. Each site must offer both treatments, with GIT-PD being less intensive than the specialist therapies at that location. During the study, participants will complete various questionnaires and interviews at eight time points from enrollment through 30 months after starting treatment. Measurements include the Level of Personality Functioning Scale and the Semi-structured Interview for Personality Functioning, among others. Researchers will monitor symptoms, disability, quality of life, and treatment costs. This long-term follow-up allows detailed analysis of how each treatment affects personality functioning over time.

The (Cost-)Effectiveness of Generalist Versus Specialist Treatment for Severe Personality Disorders'