God Representations and Personality Disorder Treatment: A Protocol and Cross-Sectional Results of a Routine Outcome Monitoring Study

Treatment of personality disorders (PDs) requires attention to struggles patients might experience with religion and/or spirituality (R/S). Not only do many people with PDs feel a general lack of meaning in their lives, but pathological self-related and interpersonal functioning are associated with more negative and distressing God representations. This has not been studied among larger samples of patients in treatment for PDs. First, we present a brief overview of the clinical, theoretical and empirical literature relevant to God representations, spiritually integrated psychotherapy and PD treatment. Second, we describe our protocol as an example of integrating a focus on God representations in regular PD treatment by measuring God representations as part of routine outcoming monitoring among patients with PDs. This was done in a naturalistic setting where Schema Therapy (ST) and Mentalization-Based Treatment (MBT) groups were offered. Among 440 PD patients, of whom 86% reported current Christian affiliation, we administered self-report questionnaires to provide therapists and patients with data on R/S, psychiatric symptoms and personality functioning to assist in treatment evaluation. Cross-sectional results are presented on sample characteristics and associations between God representations, psychiatric symptoms, early maladaptive schemas and dysfunctional schema modes.