Psychotherapy utilization and care for severely disturbed patients

Löffler-Stastka, H., Voracek, M., Leithner, K., Fischer-Kern, M., Presslich, E., Kunz, C., &  Meisel, T. (2003). Predicting psychotherapy utilization for patients with borderline personality disorder. Psychotherapy Research, 13(2), 255-264. doi: 10.1093/ptr/kpg023.
Löffler-Stastka, H., Blueml, V. & Boes, C. (2010). Exploration of personality factors and their predictive impact on therapy utilization: The externalizing mode of functioning. Psychotherapy Research, 20 (3), 295-308. DOI: 10.1080/10503300903436710.
Löffler-Stastka, H., Frantal, S., & Jandl-Jager, E. (2010). Überweisungserfolg in Psychotherapie bei Patienten mit Persönlichkeitsstörungen – Therapeutische Konsequenzen [Referral success to psychotherapy of patients with personality disorders – therapeutic consequences]. Wiener klinische Wochenschrift, 122(5-6), 165-172.

Brief Summary

Psychotherapy plays an important role in the treatment of patients suffering from a personality disorder. It is known that many patients with personality disorders do not take up psychotherapy or drop out of treatment prematurely. The aim of the present study was the detection of factors in patients with personality disorders which influence the referral to psychotherapy.

After an exploratory study with psychiatric inpatients in 2003, personality characteristics (socio-demographic parameters, affect experience and regulation, quality of object relations, character traits, level of interpersonal problems) of 297 patients of a psychoanalytic-psychotherapeutic outpatient clinic were assessed. Their influence on therapy engagement were analysed by means of logistic regressions. Within univariate analysis certain personality traits (mature psychological functioning vs. negativistic personality features) showed predictive power. The multivariate analysis identified the patients’ educational level as the principal indicator for psychotherapy utilization. Consequences for diagnostic initial interviews in connection with the role of the educational level for the therapeutic alliance are discussed. Further, the impact of economic aspects on therapy engagement is discussed.


Henriette Löffler-Stastka,

Medizinische Universität Wien, Universitätsklinik für Psychoanalyse und Psychotherapie, Währinger Gürtel 18-20, 1090 Wien