Naturalistic Outcomes of Evidence-Based Therapies for Borderline Personality Disorder at a University Clinic

2013 ◽  
Vol 61 (3) ◽  
pp. 578-584 ◽  
Author(s):  
Shilpa Sachdeva ◽  
Gregory Goldman ◽  
Georgian Mustata ◽  
Evan Deranja ◽  
Robert J. Gregory
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Evidence Based

Access to Evidence-Based Services for Individuals With Borderline Personality Disorder

2019 ◽  
pp. 155-176
Author(s):  
Peter King ◽  
Jennifer M. Martin
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Sexual Assault ◽  
Treatment Outcomes ◽  
Psychological Factors ◽  
Borderline Personality ◽  
Evidence Based ◽  
International Literature ◽  
High Prevalence ◽  
Key Features

This chapter outlines the key features of the diagnosis of borderline personality disorder. This is a diagnosis that has attracted significant levels of stigma and has generally been viewed as difficult to treat. This has resulted in often inadequate service responses for people experiencing high levels of distress. Increased understanding is facilitated by exploring precipitating factors leading to this diagnosis, including invalidating and often traumatizing environments. Available evidence from Australian and international literature is considered, with main treatments identified to inform improved treatment outcomes. The need for attention to biological, psychological factors is highlighted and in particular acknowledgment of the high prevalence of trauma, particularly childhood sexual assault, amongst the mostly women who are given this diagnosis.

Personality Disorders

2018 ◽  
Author(s):  
Carla Sharp ◽  
Jared D. Michonski
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Dialectical Behavior Therapy ◽  
Evidence Base ◽  
Borderline Personality ◽  
Evidence Based ◽  
Assessment And Treatment ◽  
Literature Base ◽  
Vantage Points ◽  
Robust Evidence

The current chapter considers personality disorder in adolescents. In keeping with the evidence-based approach taken in this volume, the focus is on adolescent borderline personality disorder (BPD), as BPD currently has the most robust evidence base in terms of assessment and treatment in adolescents. While understudied relative to other disorders of childhood and adolescents, the current chapter summarizes the nascent, but rapidly growing, literature base for the definition, prevalence, assessment, and intervention of BPD in adolescents. Assessment and intervention are considered from the vantage points of both the leading treatment approaches to BPD, namely, dialectical behavior therapy and mentalization-based treatment. The chapter concludes with a discussion of the next frontier for BPD research in adolescents.

scholarly journals Metaphors in Mentalization-Based Treatment: Reintroducing the Language of Change in “Plain Old Therapy”

2021 ◽  
Author(s):  
E. J. Folmo ◽  
T. Langjord ◽  
N. C. S. Myhrvold ◽  
M. Lind
Keyword(s):  
Borderline Personality Disorder ◽  
High Risk ◽  
Personality Disorder ◽  
Social Trust ◽  
Borderline Personality ◽  
Evidence Based ◽  
Cognitive Content ◽  
Perennial Philosophy ◽  
Evidence Based Treatments

AbstractMetaphors, a central conduit of change in psychotherapy, have not been taken adequately into account in Mentalization-Based Treatment (MBT). Despite successfully utilized by other evidence-based treatments for borderline personality disorder (BPD), MBT considers metaphors confusing for patients with low mentalizing abilities. For metaphors and teaching stories to stimulate growth within the window of tolerance, interventions should be responsively tailored (e.g., explained). Metaphors might be a route to making spoken matter more apprehensible, and bridge emotions with cognitive content. They hold the potential for challenging without being too confronting, and to translate knowledge between different range of understanding. This theoretical article presents why the use of metaphors in MBT—in the hands of a responsive therapists—may prove a powerful tool to open social trust, despite being considered a “high risk” intervention. The timeless lens of the metaphor may help us connect with archetypical versions of our own narratives, hence understanding our subjectivity in a larger perspective. By reaching towards concepts beyond our normal reasoning, typically denoted perennial philosophy or wisdom, they may substitute and/or supplement mentors in a memorable way.

scholarly journals Evidence-based psychological interventions for borderline personality disorder in the United Kingdom—who falls through the gaps?

2021 ◽  
Vol 5 (2) ◽  
pp. 148-167
Author(s):  
Kirsten Barnicot
Keyword(s):  
United Kingdom ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Evidence Base ◽  
Borderline Personality ◽  
Psychological Interventions ◽  
Evidence Based ◽  
Post Traumatic Stress ◽  
Treatment Pathways ◽  
The United Kingdom

Over the past fifteen years, access to evidence-based psychological interventions (EBPIs) for borderline personality disorder has dramatically increased in the United Kingdom. However, some patients continue to fall through the gaps. This article presents a novel analysis of evidence on patients who are currently unable to benefit from EBPIs and explores possible solutions, with particular reference to dialectical behaviour therapy and mentalization-based therapy. At one end of the spectrum, patients with less severe difficulties often do not meet the threshold for receiving EBPIs in dedicated personality disorder services. The nascent evidence base for a possible solution—implementation of streamlined versions of EBPIs in generic mental health or even primary care services—is reviewed. At the other end, a sizeable minority of patients receiving long-term EBPIs discontinue treatment prematurely and/or experience poor outcomes. This is a highly distressing experience with potential for iatrogenesis—yet the evidence base for what to do next is non-existent and follow-on treatment pathways in services are unclear. Difficulties in the therapeutic alliance, a failure to overcome epistemic hypervigilance, and therapist non-adherence to the model are reviewed as possible contributing factors. The importance of understanding the patient perspective on what happened, considering the role of both patient and therapist in contributing to difficulties, and offering patients a choice in specifying their onward treatment, is discussed. Finally, increasing access to trauma-focused EBPIs for post-traumatic stress disorder is recommended as an avenue for the future.

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