scholarly journals How do patients with borderline personality disorder experience Distress Tolerance Skills in the context of dialectical behavioral therapy?—A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252403
Author(s):  
Anja Schaich ◽  
Diana Braakmann ◽  
Mirco Rogg ◽  
Clara Meine ◽  
Julia Ambrosch ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Distress Tolerance ◽  
Qualitative Content Analysis ◽  
Behavioral Therapy ◽  
Primary Diagnosis ◽  
Borderline Personality ◽  
Dialectical Behavioral Therapy ◽  
Structured Interviews ◽  
Interpersonal Situations

Distress Tolerance Skills (DTS) are an important component of Dialectical Behavioral Therapy (DBT), a therapy method frequently used for treating patients with Borderline Personality Disorder (BPD). However, little is known about how DTS-training is experienced by individuals with BPD. The aim of this study was to explore BPD patients’ experiences with receiving DTS-training. Qualitative data were collected through semi-structured interviews with 24 individuals (87.5% females) with a primary diagnosis of BPD who received DTS-training in the context of 18 months of DBT treatment. Interview data were analyzed following the procedures of qualitative content analysis. Participants reported various effects of DTS including an immediate reduction of tension. Patients perceived DTS as a tool to cope with difficult interpersonal situations and emergencies and stated that this helped them to feel stable, safe and self-confident. Patients reported difficulties during the initial engagement, the learning process and the application of DTS as well as various facilitating factors. Implications of the findings for further research and for optimizing DTS-training in clinical practice are discussed.

Efficacy of Dialectical Behavioral Therapy for Emotion Dysregulation in Patients with dual diagnosis of Borderline Personality Disorder and Substance Use Disorder

2021 ◽  
Vol 17 ◽  
Author(s):  
Ahmed Rady ◽  
Ahmed Abdelkarim ◽  
Andre Ivanoff ◽  
Tarek Molokhia
Keyword(s):  
Substance Use ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Substance Use Disorder ◽  
Dual Diagnosis ◽  
Emotion Dysregulation ◽  
Psychological Intervention ◽  
Behavioral Therapy ◽  
Borderline Personality ◽  
Dialectical Behavioral Therapy

Background: The published evidence supports dialectical behavioral therapy (DBT) efficacy to treat patients with borderline personality disorder and particular emphasis on emotion dysregulation as a psychopathological construct. Aim: To assess the efficacy of DBT for improving emotion dysregulation among patients with a dual diagnosis of borderline personality disorder and substance use disorder. Methods: We recruited 40 patients meeting DSM-5 criteria for borderline personality disorder and substance use disorder and assigned them to two groups of 20 participants each. One group underwent DBT therapy, and the other group followed a treatment-as-usual (TAU) protocol over one year. We used the difficulties in emotion regulation scale (DERS) scores at baseline, immediately after therapy, and four months after treatment to assess emotion dysregulation. Results: We found significant improvements (p<0.05) in the DBT group after therapy that was maintained at least for four months afterward based on the DERS scores (including subscale scores). More patients dropped out of the treatment in the TAU group than in the DBT group. Conclusion: DBT is a potentially effective psychological intervention to treat emotion dysregulation in patients with borderline personality disorder and substance use disorder.

Benchmarks for Outpatient Dialectical Behavioral Therapy in Adults With Borderline Personality Disorder

2016 ◽  
Vol 28 (8) ◽  
pp. 895-906
Author(s):  
Micki Washburn ◽  
Allen Rubin ◽  
Shu Zhou
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Randomized Clinical Trials ◽  
Behavioral Therapy ◽  
Borderline Personality ◽  
Effect Sizes ◽  
Control Treatment ◽  
Dialectical Behavioral Therapy ◽  
Group Effect ◽  
Treatment As Usual

Purpose: This article provides benchmark data on within-group effect sizes from published randomized clinical trials supporting the efficacy of dialectical behavioral therapy (DBT) for borderline personality disorder (BPD) in adults aged 18–65 years. Method: Within-group effect sizes were calculated via the Glass approach and adjusted for sample size using Hedges’s g then aggregated to produce benchmarks for symptoms commonly associated with BPD, such as self-harm, depression, and anger. Results: Aggregate within-group effect sizes are presented separately for treatment (DBT) and control (treatment as usual) groups and for interviewer assessed and self-reported outcome measures. Discussion: Community-based practitioners can use these benchmarks as a comparison tool to evaluate the ways in which they are adopting or adapting the DBT intervention and to determine if the intervention should be modified or replaced, given their unique practice setting and client population.

Supportive Psychotherapy and Case Management

2017 ◽  
Author(s):  
David J. Hellerstein ◽  
Ron B. Aviram
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Case Management ◽  
Clinical Management ◽  
Behavioral Therapy ◽  
Borderline Personality ◽  
Dialectical Behavioral Therapy ◽  
Supportive Psychotherapy ◽  
Treatment Techniques ◽  
Specialized Care

Psychotherapy of borderline personality disorder (BPD) has often focused on specialized and putatively more effective treatments such as dialectical behavioral therapy. In recent years, accumulating evidence suggests that many BPD patients benefit equally well from well-structured but less specialized care designed to meet their needs. Supportive psychotherapy (SPT) and various forms of clinical management, such as structured clinical management (SCM) and general psychiatric management (GPM), have been successfully adapted for treatment of BPD. This chapter describes the theoretical backgrounds for these approaches, main treatment techniques, and how they can be implemented to provide good outcomes for individuals diagnosed with BPD.

scholarly journals Therapeutic Relationship in eHealth—A Pilot Study of Similarities and Differences between the Online Program Priovi and Therapists Treating Borderline Personality Disorder

2020 ◽  
Vol 17 (17) ◽  
pp. 6436
Author(s):  
Sandra Köhne ◽  
Ulrich Schweiger ◽  
Gitta A. Jacob ◽  
Diana Braakmann ◽  
Jan Philipp Klein ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Therapeutic Alliance ◽  
Therapeutic Relationship ◽  
Qualitative Content Analysis ◽  
Treatment Phase ◽  
Borderline Personality ◽  
Structured Interviews ◽  
One Year ◽  
The Relationship

eHealth programs have been found to be effective in treating many psychological conditions. Regarding Borderline Personality Disorder (BPD), few programs have been tested; nevertheless, results are promising. The therapeutic alliance is an important factor predicting treatment outcome in BPD. However, we do not know yet to what extent BPD patients form a therapeutic alliance with an eHealth tool and how this relationship differs from the relationship with their human therapist. This study aims to address this question using priovi, an interactive schema therapy-based eHealth tool for BPD. Semi-structured interviews were conducted to explore how patients perceived the therapeutic alliance with priovi and its differences compared to the alliance with their human therapist (N = 9). Interview data were analyzed following the procedures of qualitative content analysis. Additionally, the Working Alliance Inventory (WAI-SR) was administered in two versions (regarding the human therapist and priovi, N = 16) every three months during the treatment phase of one year. Results indicate that patients were able to form a good therapeutic relationship with priovi, but it differed from the relationship to their human therapist. Important categories were “priovi is helpful, supportive and always there” and “priovi is less flexible”. WAI ratings for the task subscale were high in both relationships but significantly higher in WAItherapist compared to WAIpriovi in two measurements (nine-months measurement: t = 2.76, df = 15, p = 0.015; twelve-months measurement: t = 3.44, df = 15, p = 0.004). These results indicate that BPD patients can form a functioning alliance with an eHealth program and that eHealth programs may be especially useful for psychoeducation and cognitive exercises.

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