ABSTRACT
Functioning describes how well a person handles life, but the constituents of functioning and its measurement remain subjects of debate among researchers. However, approaches investigating how the concept of functioning is understood among laypeople and practitioners have received less attention. The present study uses a bottom-up approach to explore the concept of functioning among laypeople and mental health professionals in a Scandinavian context. Participants were asked to describe a person doing well in life and a person not doing well in life, resulting in a total of 2,345 statements from 128 laypeople and 78 mental health professionals. Initially, statements were rated according to the meta-concepts of Agency and Communion. This analysis revealed a dominant prevalence of Agency across groups, with laypeople demonstrating a heightened emphasis on Agency when characterizing an individual not doing well in life, suggesting an intensified focus on personal responsibility and achievement when describing dysfunction. Next, an independent semantic domain analysis was used to elucidate and identify distinctive features of functioning within the statements. This revealed a shared conceptualization of functioning among both laypeople and mental health professionals based on three main domains: (1) thriving; (2) daily activities and social roles; and (3) personality features. The findings underscore the importance of considering subjective experiences of thriving, efficacy in managing daily tasks and roles, and personality traits in attaining a comprehensive understanding of functioning levels.
ABSTRACT
Borderline personality disorder (BPD) is characterized by severe disturbances related to understanding oneself and other people and can be reliably detected and treated in adolescence. In this feasibility study, we aimed to focus on the features of, and changes in, narrative identity throughout the course of Mentalization-Based Treatment in Groups (MBT-G) for adolescents with BPD. Six female patients (M = 15.2, SD = 0.75) joined between 16 and 31 (M = 23.83) MBT g sessions. The narrated events within each session across sessions were coded for themes of agency and communion and the narrated reactions were coded for personality functioning. The patients and their parents also completed several self-report measures before and after therapy. Themes of diminished agency and communion were identified, with communion as the dominating theme. When comparing the patients' first five sessions with their last five sessions, there was an increase in themes related to agency and decreased in communion. The narrated reactions were dominated by themes related to thwarted self-functioning and primarily identity, although intimacy was also present. Patients improved in terms of self-reported functioning and internalizing and externalizing behavior before and after end of treatment. The importance of narration in BPD (group) therapy is discussed alongside clinical implications.
