Quale Comunit Terapeutica per il Paziente Borderline L Esperienza del Cassel Hospital

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Quale Comunitá Terapeutica per il Paziente
Borderline?L Esperienza del Cassel Hospital

• Milano 17 Novembre 2007
• Dr Marco Chiesa

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Roth, A., Fonagy, P. (2005) What Works for
Whom A Critical Review of Psychotherapy Research
(2nd ed.) New York Guilford Press Chiesa, M.
(2005) Hospital-based psychosocial treatment of
borderline personality disorder A systematic
review of rationale and evidence-base Clinical
Neuropsychiatry, 2, 292-301
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• Gowers, S. G.et al. (2007) Clinical effectiveness
  of treatments for anorexia nervosa in
  adolescents Randomised controlled trial, Br J
  Psychiatry, 191, 427-435
• Byford, S. et al. (2007) Economic evaluation of a
  randomised controlled trial for anorexia nervosa
  in adolescents. Br J Psychiatry, 191, 436-440

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Change in psychiatric morbidity and social
adjustment
Chiesa et al. (2002). Patients characteristics,
outcome and cost-benefit of hospital-based
treatment for patients with personality disorder
A comparison of three treatment programmes.
Psychology and Psychotherapy, 75, 381-393.
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Residential programme

• Twice weekly individual psychodynamic
  psychotherapy
• Weekly group psychotherapy
• Daily Unit meetings
• 4-times weekly community meetings
• Daily workgroups
• Daily structured activities
• Planning and running of hospital
• Two-monthly reviews
• Psychotropic medication

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Features of the Programme

• Structured
• Individualized care plans
• Consistency and integrity
• Theoretically coherent
• Intensive flexible
• Relationship focus
• Independent dedicated

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Attrition rates in the residential and in the
community programmes
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Self-mutilation
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Parasuicidal Behaviour