Adaptation of the Motive-Oriented Therapeutic Relationship Scale to group setting in dialectical-behaviour therapy for borderline personality disorder

The therapeutic relationship as a process is usually studied in individual therapy, and less in group therapy. One reason for this paucity of research may be the complex methodology necessary to do process research on group therapy. One of the therapeutic approaches using the group as part of the therapy is dialectical behavior therapy (DBT) for borderline personality disorder (BPD). The purpose of the present study is to develop a group version of a process measure that has been successfully used in individual therapy, the Motive-Oriented Therapeutic Relationship (MOTR) scale, based on individualized case conceptualizations using the Plan Analysis approach. To do this, 10 sessions of a DBT skills group therapy were analyzed from a comprehensive dataset within a randomized controlled trial. Included were therapy completers: 3 patients and 2 therapists. The therapists were unaware of MOTR. The results revealed that the adaptation of the MOTR to DBT skills group was feasible. Its adaptation showed differences of the therapists in their use of MOTR when comparing the different patients: Therapist presented with higher degrees of MOTR toward 1 patient, compared to another. Overall results suggest that effective therapists in DBT skills training intervene with rather low mean levels of MOTR, and great intrasession variability of MOTR. We conclude that the adaptation of the MOTR-instrument to group therapy is feasible and yields meaningful results. Therefore, this scale may be used in process research in group therapy, in particular when 1 wishes to have an individualized measure of the therapeutic relationship.