Go to the article page in English / Pojdi na angleško stran članka
Program STEPPS kot možna oblika pomoči posameznikom z mejno osebnostno motnjo
Jerica Radež in Meta Shawe-Taylor
Polno besedilo (pdf) | Ogledi: 222 | 
Napisan v slovenščini. | Objavljeno: 12. junij 2015
https://doi.org/10.20419/2015.24.422 | Citati: CrossRef (0)
Povzetek: Mejna osebnostna motnja je kompleksna psihična motnja, ki pomembno vpliva na vsa področja posameznikovega delovanja. Ker predstavlja najpogostejšo motnjo osebnosti na populaciji bolnikov z duševnimi motnjami in ker je relativno odporna na farmakološko zdravljenje, je oblikovanje učinkovitih psihoterapevtskih pristopov ključnega pomena za nadaljnjo obravnavo teh bolnikov. V preteklosti je bilo razvitih več psihoterapevtskih metod, ki so namenjene posameznikom z mejno osebnostno motnjo. Le-te po večini izhajajo iz dveh večjih terapevtskih paradigem, in sicer kognitivno-vedenjske in psihoanalitične. V zadnjem času pa se spodbuja raziskovanje pristopov, ki vključujejo elemente različnih psihoterapevtskih smeri. Enega izmed takšnih predstavlja program STEPPS, ki poleg različnih metod kognitivno-vedenjske terapije vključuje tudi elemente sistemske terapije. Program STEPPS je 20-tedenski program skupinske psihoterapije za posameznike z mejno osebnostno motnjo. Za razliko od večine preostalih pristopov je zasnovan kot podpora obstoječemu načinu zdravljenja. V pričujočem članku predstavljamo osnovne značilnosti programa STEPPS in pregled dosedanjih študij, ki so proučevale njegovo učinkovitost pri zdravljenju posameznikov z mejno osebnostno motnjo. Poleg tega ponujamo kritično oceno programa STEPPS v kontekstu dosedanjih psihoterapevtskih pristopov in predlagamo smernice za njegovo nadaljnje raziskovanje.
Ključne besede: mejna osebnostna motnja, STEPPS, kognitivno-vedenjska terapija, družinska sistemska terapija, učinkovitost psihoterapije
Citiraj:
Radež, J. in Shawe-Taylor, M. (2015). Program STEPPS kot možna oblika pomoči posameznikom z mejno osebnostno motnjo [The STEPPS Group Treatment Program as an alternative in helping people with borderline personality disorder]. Psihološka obzorja, 24, 13–20. https://doi.org/10.20419/2015.24.422
Seznam literature v članku
American Psychiatric Association. (2001). Practice guideline for the treatment of patients with borderline personality disorder. Washington, DC, ZDA: American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and statictical manual of mental disorders (5. izd.). Washington, DC, ZDA: American Psychiatric Publishing.
Alesiani, R., Boccalon, S., Giarolli, L., Blum, N. in Fossati, A. (2014). Systems Training for Emotional Predictability and Problem Solving (STEPPS): program efficacy and personality features as predictors of drop-out - an Italian study. Comprehensive Psychiatry, 55(4), 920–7. CrossRef
Bartels, N. in Crotty, T. (1998). A systems approach to treatment: The borderline personality disorder skill training manual. Winfield, IL, ZDA: EID Treatment Systems.
Bateman, A. W. in Fonagy, P. (2001). Treatment of borderline personality disorder with psychoanalytically oriented partial hospitalization: An 18-month follow-up. American Journal of Psychiatry, 158, 36–42. CrossRef
Beck, A. T., Freeman, A. in Davis, D. D. (2004). Cognitive therapy of personality disorders. New York, NY, ZDA: Guildford Press.
Benedik, E. (2014). Za integrirano in celostno psihoterapijo osebnosti: značilnosti psihtoerapevtske obravnave pacientov z mejno osebnostno motnjo [Towards integrative and holistic psychotherapy: characteristics of psychotherapeutic treatment of patients with borderline personality disorder]. Kairos, 8(1), 12–24.
Black, D. W., Blum, N., Pfohl, B. in St John, D. (2004). The STEPPS group treatment program for outpatients with borderline personality disorder. Journal of Contemporary Psychotherapy, 34(3), 193–210. CrossRef
Black, D. W., Allen, J., St John, D., Pfohl, B., McCormick, B. in Blum, N. (2009). Predictors of response to Systems Training for Emotional Predictability and Problem Solving (STEPPS) for borderline personality disorder: An exploratory study. Acta Psychiatrica Scandinavica, 120(1), 53–61. CrossRef
Black, D. W., Blum, N., McCormick, B. in Allen, J. (2013). Systems Training for Emotional Predictability and Problem Solving (STEPPS) group treatment for offenders with borderline personality disorder. The Journal of Nervous and Mental Disease, 201(2), 124–9. CrossRef
Blum, N., Pfohl, B., St. John, D., Monahan, P. in Black, D. W. (2002). STEPPS: A cognitive-behavioral systems-based group treatment for outpatient clients with borderline personality disorder — a preliminary report. Comprehensive Psychiatry, 43, 301–310. CrossRef
Blum, N., St. John, D., Pfohl, B., Stuart, S., Mccormick, B., Allen, J., Arndt, S. in Black, D. W. (2008). Systems Training for Emotional Predictability and Problem Solving (STEPPS) for Outpatients With Borderline Personality Disorder: A randomized trial. American Journal of Psychiatry, 165(4), 468–478. CrossRef
Bos, E. H., van Wel, E. B., Appelo, M. T. in Verbraak, M. J. P. M. (2010). A randomized controlled trial of a Dutch version of systems training for emotional predictability and problem solving for borderline personality disorder. The Journal of Nervous and Mental Disease, 198(4), 299–304. CrossRef
Bos, E. H., van Wel, E. B., Appelo, M. T. in Verbraak, M. J. P. M. (2011). Effectiveness of Systems Training for Emotional Predictability and Problem Solving (STEPPS) for borderline personality problems in a "real-world" sample: Moderation by diagnosis or severity? Psychotherapy and Psychosomatics, 80(3), 173–81. CrossRef
Bourke, M. E. in Grenyer, B. F. S. (2013). Therapists' accounts of psychotherapy process associated with treating patients with borderline personality disorder. Journal of Personality Disorders, 27(6), 735–745. CrossRef
Clarkin, J. F., Yeomans, F. in Kernberg, O. F. (1999). Psychotherapy of Borderline Personality. New York, NY, ZDA: Wiley.
Davidson, K., Norrie, J., Tyrer, P., Gumley, A., Tata, P., Murray, H. in Palmer, S. (2006). The effectiveness of cognitive behavior therapy for borderline personality disorder: Results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial. Journal of Personality Disorders, 20, 450–465. CrossRef
Dixon-Gordon, K. L., Turner, B. J. in Chapman, A. L. (2011). Psychotherapy for personality disorders. International Review of Psychiatry, 23(May), 282–302. CrossRef
Grant, B. F., Chou, S. P., Goldstein, R. B., Huang, B., Stinson, F. S., Saha, T. D., Smith, S. M., Dawson, D. A., Pulay, A. J., Pickering, R. P. in Ruan, W. J. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. The Journal of Clinical Psychiatry, 69(4), 533–45. CrossRef
Harvey, R., Black, D. W. in Blum, N. (2010). Systems Training for Emotional Predictability and Problem Solving (STEPPS) in the United Kingdom: A preliminary report. Journal of Contemporary Psychotherapy, 40(4), 225–232. CrossRef
Hayes, S. C., Strosahl, K. in Wilson, K. G. (1999). Acceptance and Commitment Therapy: An experiential approach to behaviuor change. New York, NY, ZDA: Guilford Press.
Korzekwa, M. I., Dell, P. F., Links, P. S., Thabane, L. in Webb, S. P. (2008). Estimating the prevalence of borderline personality disorder in psychiatric outpatients using a two-phase procedure. Comprehensive Psychiatry, 49(4), 380–6. CrossRef
Linehan, M. M. (1993). Cognitive-behavioural treatment of borderline personality disorder. New York, NY, ZDA: Guildford Press.
Marziali, E. in Monroe-Blum, H. (1995). An interpersonal approach to group psychotherapy with borderline personality disorder. Journal of Personality Disorders, 9(3), 179–189. CrossRef
Minuchin, S. (1974). Family and family therapy. Cambridge, MA, ZDA: Harvard University Press.
Pfohl, B. in Blum, N. (1997). Borderline evaluation of severity over time. Neobjavljen vprašalnik, Oddelek za psihiatrijo, Univerza v Iowi, Iowa, ZDA
Riemann, G., Weisscher, N., Goossens, P. J. J., Draijer, N., Apenhorst-Hol, M. in Kupka, R. W. (2014). The addition of STEPPS in the treatment of patients with bipolar disorder and comorbid borderline personality features: A protocol for a randomized controlled trial. BMC Psychiatry, 14, 172. CrossRef
Ripoll, L. H. (2013). Psychopharmacologic treatment of borderline personality disorder. Dialogues in Clinical Neuroscience, 15(2), 213–24.
Shawe-Taylor, M., Geoghegan, M. in Hill, N. (v tisku). STEPPS Programme: Report on STEPPS outcomes - Working age adults, East locality. Notranje poročilo organizacije Surrey and Borders Partnership, NHS Foundation Trust. Leatherhead, Združeno kraljestvo: Surrey and Borders Partnership, NHS Foundation Trust.
Skodol, A. E., Buckley, P. in Charles, E. (1983). Is there a characteristic pattern to the treatment history of clinic outpatients with borderline personality? The Journal of Nervous and Mental Disease, 171(7), 405–10. CrossRef
Tomko, R. L., Trull, T. J., Wood, P. K. in Sher, K. J. (2014). Characteristics of borderline personality disorder in a community sample: Comorbidity, treatment utilization, and general functioning. Journal of Personality Disorders, 28(5), 734–50.CrossRef
Van Wel, B., Kockmann, I., Blum, N., Pfohl, B., Black, D. W. in Heesterman, W. (2006). STEPPS group treatment for borderline personality disorder in The Netherlands. Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists, 18(1), 63–7. CrossRef
Wells, A. (2009). Metacognitive therapy for anxiety and depression. New York, NY, ZDA: Guilford Press.
Widiger, T. A. in Weissman, M. M. (1991). Epidemiology of borderline personality disorder. Hospital & Community Psychiatry, 42(10), 1015–21. CrossRef
Yeomans F. E., Levy K. N. in Meehan, K. B. (2012). Treatment approaches for borderline personality disorder. Psychiatric Times, 42–47.
Young, J. E. (1999). Cognitive therapy for personality disorders: A schema-focused approach. Sarasota, FL, ZDA: Professional Resource Press.
Zanarini, M. C. (2009). Psychotherapy of borderline personality disorder. Acta Psychiatrica Scandinavica, 120(5), 373–7. CrossRef
