Clinical supervision over complex cases of personality disorders according to metacognitive interpersonal therapy

Treating patients with Personality Disorders (PDs) means dealing with what are often referred to as complex cases. The complexity of cases stems from several variables and in particular: the high percentage of diagnostic co-occurrences, patients' difficulty in reflecting on their own and others' mental states (i.e., metacognitive impairments), and the strong emotional pressure experienced by therapists. All this results in difficulties in building the therapeutic alliance and high drop-out rates. For these reasons, therapists often need supervision, with a more experienced therapist or even among peers. This article proposes the structured supervision model according to Metacognitive Interpersonal Therapy (MIT), which is an evidence-based treatment model for PDs.