Clients with borderline personality disorder: Exploring their experiences of dialectical behaviour therapy

Objectives: Borderline personality disorder is a complex mental disorder that is associated with a high degree of suffering for the individual. Dialectical behaviour therapy has been studied in the largest number of controlled trials for treatment of individuals with borderline personality disorder. The conversational model is a psychodynamic treatment also developed specifically for treatment of borderline personality disorder. We report on the outcomes of a randomised trial comparing dialectical behaviour therapy and conversational model for treatment of borderline personality disorder in a routine clinical setting. Method: Participants had a diagnosis of borderline personality disorder and a minimum of three suicidal and/or non-suicidal self-injurious episodes in the previous 12 months. Consenting individuals were randomised to either dialectical behaviour therapy or conversational model and contracted for 14 months of treatment ( n = 162 commenced therapy). Dialectical behaviour therapy involved participants attending weekly individual therapy, weekly group skills training and having access to after-hours phone coaching. Conversational model involved twice weekly individual therapy. Assessments occurred at baseline, mid-treatment (7 months) and post-treatment (14 months). Assessments were conducted by a research assistant blind to treatment condition. Primary outcomes were change in suicidal and non-suicidal self-injurious episodes and severity of depression. We hypothesised that dialectical behaviour therapy would be more effective in reducing suicidal and non-suicidal self-injurious behaviour and that conversational model would be more effective in reducing depression. Results: Both treatments showed significant improvement over time across the 14 months duration of therapy in suicidal and non-suicidal self-injury and depression scores. There were no significant differences between treatment models in reduction of suicidal and non-suicidal self-injury. However, dialectical behaviour therapy was associated with significantly greater reductions in depression scores compared to conversational model. Conclusion: This research adds to the accumulating body of knowledge of psychotherapeutic treatment of borderline personality disorder and supports the use of both dialectical behaviour therapy and conversational model as effective treatments in routine clinical settings, with some additional benefits for dialectical behaviour therapy for persons with co-morbid depression.

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A cost-effectiveness analysis of dialectical behaviour therapy for treating individuals with borderline personality disorder in the community

Irish Journal of Medical Science (1971 -) ◽

10.1007/s11845-019-02091-8 ◽

2019 ◽

Vol 189 (2) ◽

pp. 415-423 ◽

Cited By ~ 4

Author(s):

Aileen Murphy ◽

Jane Bourke ◽

Daniel Flynn ◽

Mary Kells ◽

Mary Joyce

Keyword(s):

Cost Effectiveness ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Cost Effectiveness Analysis ◽

Borderline Personality ◽

Behaviour Therapy ◽

Dialectical Behaviour Therapy ◽

Effectiveness Analysis

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Hunter DBT Project: Randomized Controlled Trial of Dialectical Behaviour Therapy in Women with Borderline Personality Disorder

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048670903393621 ◽

2010 ◽

Vol 44 (2) ◽

pp. 162-173 ◽

Cited By ~ 69

Author(s):

Gregory L. Carter ◽

Christopher H. Willcox ◽

Terry J. Lewin ◽

Agatha M. Conrad ◽

Nick Bendit

Keyword(s):

Randomized Controlled Trial ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Controlled Trial ◽

Borderline Personality ◽

Behaviour Therapy ◽

Dialectical Behaviour Therapy ◽

Randomized Controlled

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THE TREATMENT OF DELIBERATE SELF-HARM IN BORDERLINE PERSONALITY DISORDER USING DIALECTICAL BEHAVIOUR THERAPY: A PILOT STUDY IN A HIGH SECURITY HOSPITAL

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465801001096 ◽

2001 ◽

Vol 29 (1) ◽

pp. 85-92 ◽

Cited By ~ 42

Author(s):

Gail Low ◽

David Jones ◽

Conor Duggan ◽

Mick Power ◽

Andrew MacLeod

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Suicide Ideation ◽

Borderline Personality ◽

Institutional Setting ◽

Behaviour Therapy ◽

Deliberate Self Harm ◽

Dialectical Behaviour Therapy ◽

Self Harm

Deliberate self-harm (DSH) presents a significant health problem, especially as treatments have not been particularly successful in reducing repetition. Dialectical behaviour therapy (DBT; Linehan, 1993) is one approach that has reported some success in reducing self-harm rates in borderline personality disorder patients, who self-harm frequently, though it remains largely untested outside its original setting. The present study aimed to assess the effectiveness of DBT in self-harming women in an institutional setting in the United Kingdom where self-harm is common. Female patients at Rampton Hospital who were displaying self-harming behaviour and met criteria for borderline personality disorder (N = 10) participated in the full one-year treatment package of DBT. Patients were assessed on self-harm rates and on a number of psychological variables, pre-, during- and post-therapy, including a 6-month follow-up. There was a significant reduction in DSH during therapy, which was maintained at 6-month follow-up. This was paralleled by a reduction in dissociative experiences and an increase in survival and coping beliefs, alongside improvements in depression, suicide ideation, and impulsiveness. The findings are preliminary but the results suggest that DBT might provide an effective treatment for severe self-harm in institutional settings, and also highlight some of the psychological mechanisms that might mediate these improvements in self-harming behaviour.

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