Psychoanalysis Unit


Marco Chiesa

Marco Chinesa

Dr Marco Chiesa MD, FRCPsych was Consultant Psychiatrist in Psychotherapy at the Cassel Hospital, Richmond 1991-2015. He was Director of the outpatient Adult Personality Disorder Service, which he developed and expanded over the years. The unit provides assessment and community-based psychosocial treatment for personality-disordered (mostly borderline) patients who reside within the London area. He was also Director of the Research Unit at the Cassel Hospital where he carried out a number of research projects in the field of treatment outcome for personality disorder and psychodynamic psychotherapy.

He was a Visiting Consultant at the Cardinal Clinic in Windsor for three years and has been working in private practice in SW London for over 25 years. His main interest is the treatment and management of patients with personality disorder and patients with psychiatric syndromes with associated personality disorder.

After graduating in Medicine at Milan University Medical School, he specialised in General Psychiatry both at Milan University and in London within the Charing Cross Hospital postgraduate training scheme, becoming first a Member and then a Fellow of the Royal College of Psychiatrists. He specialised further in Family Therapy at the Milan Centre for Family Studies and qualified as Member and then Fellow of the London Institute of Psychoanalysis.

Recent Publications (since 2000)

· Chiesa, M. & Fonagy, P. (2000) Cassel personality disorder study: Methodology and treatment effects, British Journal of Psychiatry176: 485-491

· Chiesa, M., Drahorad, C. & Longo, S. (2000) Early termination of treatment in personality disorder treated in a psychotherapy hospital: A quantitative and qualitative study, British Journal of Psychiatry 177: 107-111

· Chiesa, M. (2000) Hospital adjustment in personality disorder patients admitted to a therapeutic community milieu, British Journal of Medical Psychology 73: 259-267

· Chiesa, M., Brambilla, D. & Simoncelli, K. (2001) A contribution to the problem of diagnosis in psychotherapy: An empirical study (in Italian) Psichiatria e Territorio 18: 26-32

· Pringle, P. & Chiesa, M. (2001) From the therapeutic community to the community: Developing an outreach psychosocial nursing service for severe personality disorder, Therapeutic Communities 22: 215-232

· Chiesa, M., Fonagy, P., Holmes, J., Drahorad, C. & Harrison-Hall, A. (2002) Health service use costs by personality disorder following specialist and non-specialist treatment: A comparative study, Journal of Personality Disorders 16: 160-173

· Chiesa, M., Bateman, A., Friis, S. & Wiberg, T. (2002) Patients characteristics, outcome and cost-benefit of hospital-based treatment for patients with personality disorder: A comparison of three treatment programmes, Psychology and Psychotherapy 75: 381-393

· Chiesa, M. & Fonagy, P. (2002) From the therapeutic community to the community: A preliminary evaluation of a psychosocial outpatient service for personality disorder, Therapeutic Communities 23: 247-259

· Chiesa, M., Fonagy, P., Holmes, J. (2003) When less is more: An exploration of psychoanalytically oriented hospital-based treatment for severe personality disorder, International Journal of Psychoanalysis 84: 637-650

· Chiesa, M., Wright, M. & Neeld, R. (2003) A description of an audit cycle of early dropouts from an inpatient psychotherapy unit,Psychoanalytic Psychotherapy 17: 138-149

· Chiesa, M. (2003) Treatment approaches to the multi-problem family in specialist settings: The current state of the evidence base (in Italian), Abilitazione e Riabilitazione 12: 19-32

· Chiesa, M., Pringle, P & Drahorad, C. (2003) Users' views of therapeutic community treatment: A satisfaction survey at the Cassel Hospital, Therapeutic Communities 24: 129-143

· Chiesa, M. & Fonagy, P. (2003) Psychosocial treatment of personality disorder: 36-months follow-up, British Journal of Psychiatry183: 356-362

· Chiesa, M. (2003) The shattering of expectations: A study of early dropout in the therapeutic community (in Italian), Religioni e Sette18: 26-32

· Chiesa, M., Fonagy, P., Holmes, J., & Drahorad, C. (2004) Residential versus community treatment of personality disorder: A comparative study of three treatment programs, American Journal of Psychiatry 161: 1463-1470

· Chiesa, M., Wright, M. & Leger, D. (2004) The role of psychotropic medication in the therapeutic community: A survey of prescribing practices, Therapeutic Communities 25: 135-148

· Chiesa, M. (2005) Modernisation or privatisation? Implications of recent reforms for the future of the NHS and for psychotherapy services, Psychoanalytic Psychotherapy 19: 71-85

· Chiesa, M. (2005) Stigma and personality disorder (in Italian), Noos Aggiornamenti in Psichiatria 11: 185-196

· Chiesa, M. (2005) Can psychoanalytic research integrate and improve knowledge for the clinician? Some reflections and an example, The Scandinavian Psychoanalytic Review 28: 31-39

· Chiesa, M. (2005) Hospital-based psychosocial treatment of borderline personality disorder: A systematic review of rationale and evidence-base Clinical Neuropsychiatry 2: 292-301

· Beecham, J., Sleed, M., Knapp, M., Chiesa, M. & Drahorad, C. (2006) The cost and effectiveness of two psychosocial treatment programmes for severe personality disorder European Psychiatry 21: 102-109

· Chiesa, M., Fonagy, P. & Holmes, J. (2006) 6-year follow-up of three treatment programmes for personality disorder, Journal of Personality Disorders 20: 493-509

· Chiesa, M., Harrison, M. & Liburdi, R. (2006) Psychosocial impairment and medium-term outcome in schizotypal personality disorder (in Italian) Psichiatria e Territorio 23: 1-8

· Chiesa, M. (2007) Pathological organisations of the personality: A clinical case study, British Journal of Psychotherapy 35: 395-410

· Chiesa, M. & Fonagy, P. (2007) Prediction of medium-term outcome in Cluster B personality disorder following residential and outpatient psychosocial treatment, Psychotherapy and Psychosomatics 76: 347-353

· Chiesa, M., Fonagy, P. & Bateman, A. (2007) Differences in clinical characteristics between patients assessed for NHS specialist psychotherapy and primary care counselling, Psychology and Psychotherapy 80: 591-603

· Chiesa, M. (2007) Advances in quantitative research in psychotherapy and the importance of single case studies (in Portuguese),Revista Brasileira de Psicoterapia 9: 263-275

· Chiesa, M. (2007) Treatment of severe personality disorder: the central role of the interpersonal relationship as therapeutic factor (in Portuguese), Revista Brasileira de Psicoterapia 9: 134-143

· Chiesa, M. (2008) Referral to tertiary psychotherapy services: The road to nowhere? Psychoanalytic Psychotherapy22: 75-87

· Santiccioli, S. & Chiesa, M. (2008) Advances in the treatment of personality disorder at the Cassel Hospital and their relevance to the Italian mental health system (in Italian), Psichiatria e Territorio 25: 1-7

· Chiesa, M., Bateman, A., Fonagy, P. & Mace, C. (2009) Psychiatric morbidity and treatment pathway outcomes of patients presenting to specialist psychodynamic psychotherapy services: Results from a multi-centre study, Psychology and Psychotherapy 82: 83-98

· Chiesa, M., Fonagy, P. & Gordon, J. (2009) Community-based psychodynamic treatment of severe personality disorder: Clinical description and naturalistic evaluation, Journal of Psychiatric Practice 15: 12-24

· Chiesa, M. & Healy, K. (2009) The struggle to establish a research culture in the psychotherapy hospital: Reflections from the Cassel Hospital experience, Bulletin of the Menninger Clinic 73: 157-174

· Chiesa, M. (2010) Research and psychoanalysis: Still time to bridge the great divide? Psychoanalytic Psychology 27: 99-114

· Chiesa, M., Martino, F. & Pozzi, E. (2010) Psychosocial treatment refusal in personality disorder, Personality and Mental Health 4: 64-74

· Chiesa, M. (2010) Institutional impact of scientific research, British Journal of Psychotherapy 26: 458-464

· Chiesa, M. (2010) Anti-therapeutic factors in the long-term residential treatment of personality disorder (in Italian), Psichiatria di Comunitá 9: 113-119

· Ribeiro, L., Target, M., Chiesa, M., Bateman, A., Stein, R. & Fonagy, P. (2010) The Problematic Object Representation Scales (PORS): Assessing object relations in personality disorder through the AAI protocol, Bulletin of the Menninger Clinic 74: 329-353

· Chiesa, M., Sharp, R. & Fonagy, P. (2011) Clinical associations of deliberate self-injury and its impact on the outcome of community-based and long-term inpatient treatment for personality disorder, Psychotherapy and Psychosomatics 80: 100-109

· Chiesa, M. & Fonagy, P. (2010) Scientific research, the therapeutic community and psychodynamic psychotherapy, Clinical Neuropsychiatry 8: 1-8

· Martinucci, M., Chiesa, M., Taponecco, C., Biagi, A. & Di Fiorino, M. (2011) Borderline personality disorder and bipolar spectrum: Preliminary data on temperament and core psychopathological features in a sample of borderline patients (in italian), Giornale Italiano di Psicopatologia 17: 383-388

· Chiesa, M., Hanton, R. & Fonagy, P. (2011) Clinical associations of deliberate self-injury and its impact on the outcome of community-based and long-term inpatient treatment for personality disorder, Psychotherapy and Psychosomatics 80: 100-109

· Chiesa, M. (2013) Treatment intensity with patients with borderline personality disorder with reference to early adversity (in Italian), Psiche http://psiche-spi.it/incontrarsiodirsiaddio/3/CHIESA-SECONDEBOZZE.pdf

· Chiesa, M. & Fonagy, P. (2014) Reflective function as mediator between early adversity, personality disorder and symptom distress, Personality and Mental Health 8: 52-66

· Faria, A., Chiesa, M., Mello, M, Andreoli, S, Bressan, R, Mari, J, Silveira, D (2015) Borderline personality disorder and post-traumatic stress disorder: a comparative study of childhood trauma, PLOS ONE (submitted)

· Chiesa, M. & Cirasola, A. (2016) Systematic review on the clinical effectiveness of therapeutic communities in the treatment of severe personality disorder (in italian), Funzione Gamma (in press)

· Chiesa, M., Williams, R., Cirasola, A, & Fonagy, P. (2016) Categorical and dimensional approaches in the evaluation of the relationship between attachment and severe personality disorders: An empirical study Personality Disorders (submitted)

· Chiesa, M., et al. (2016) The relationship between childhood adversity, personality disorder and clinical severity, Psychoanalytic Psychotherapy (in press)

· Cirasola, A., Fonagy, P., Hillman, S. & Chiesa, M. (2016) Mapping the road from childhood adversity to personality disorder: The role of unresolved states of mind, Clinical Psychology and Psychotherapy (submitted)

· Hinshelwood, R. D. & Chiesa, M. (eds) (2002) Organisations, Anxieties and Defences: Towards a Psychoanalytical Social Psychology London: Whurr Publishers

· Chiesa, M (2016) Empirical Investigations in Personality Disorder: The relevance of Scientific Research for Clinical Practice (in Italian) Rome: Aracne Editrice

Contact details and London private practice: 

140 Palewell Park, East Sheen, London SW14 8JH 

Tel: +44(0)20 8392 2896