Laurel L. Williams

The development of a mentalization-based outcomes and research protocol for an adolescent inpatient unit.

The authors describe the development of a theory-driven assessment and research protocol at the Adolescent Treatment Program of The Menninger Clinic. First, the theoretical framework behind a mentalization-based model for assessment and treatment is described. Next, the process whereby measures were selected to operationalize key components of the mentalization-based model is discussed, including a brief discussion of each measure and assessment procedure. The next section describes the clinical and research use of the data collected. Here, the authors describe how outcomes assessment information is integrated into the clinical decision-making process, and they outline the research questions they aim to answer through the assessment protocol. The authors conclude with a section on the challenges, pitfalls, and future directions of the project.

Borderline Personality Disorder in Adolescence: The Case for Medium Stay Inpatient Treatment

BACKGROUND The diagnosis of personality disorders in adolescents has been a topic of debate in recent years. METHOD This manuscript reviews the case of an adolescent girl admitted for a medium length combined inpatient and partial hospitalization program. This program has developed protocols to assess for Axis I and II pathology as well as various psychological processes. Comprehensive outcome measures were administered to the patient at discharge and follow-up. RESULTS/CONCLUSIONS Diagnosis of a personality disorder in adolescence appears to be associated with psychological processes usually identified in adults. Against the background of an emerging debate about the need to reform a culture of ultra-short inpatient care, this case study provides some support for more thorough assessment, diagnosis, and treatment of adolescents who appear to have comorbid Axis I and II disorders.