Making Contact with the Self-Injurious Adolescent: Borderline Personality Disorder, Gestalt Therapy, and Dialectical Behavioral Therapy Interventions

2010 ◽  
Vol 14 (3) ◽  
pp. 250 ◽  
Author(s):  
Lynn Williams, Ph.D.
PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252403
Author(s):  
Anja Schaich ◽  
Diana Braakmann ◽  
Mirco Rogg ◽  
Clara Meine ◽  
Julia Ambrosch ◽  
...  

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.


Author(s):  
Ahmed Rady ◽  
Ahmed Abdelkarim ◽  
Andre Ivanoff ◽  
Tarek Molokhia

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.


2016 ◽  
Vol 28 (8) ◽  
pp. 895-906
Author(s):  
Micki Washburn ◽  
Allen Rubin ◽  
Shu Zhou

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.


Author(s):  
David J. Hellerstein ◽  
Ron B. Aviram

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.


2017 ◽  
Vol 30 (4) ◽  
pp. 307
Author(s):  
Sofia Marques ◽  
Daniel Barrocas ◽  
Daniel Rijo

Introduction: Borderline personality disorder is the most common personality disorder, with a global prevalence rate between 1.6% and 6%. It is characterized by affective disturbance and impulsivity, which lead to a high number of self-harm behaviors and great amount of health services use. International guidelines recommend psychotherapy as the primary treatment for borderline personality disorder. This paper reviews evidence about the effects and efficacy of cognitive-behavioral oriented psychological treatments for borderline personality disorder.Material and Methods: A literature review was conducted in Medline and PubMed databases, using the following keywords: borderline personality disorder, cognitive-behavioral psychotherapy and efficacy.Results: Sixteen randomized clinical trials were evaluate in this review, which analyzed the effects of several cognitive-behavioral oriented psychotherapeutic interventions, namely dialectical behavioral therapy, cognitive behavioral therapy, schema-focused therapy and manual-assisted cognitive therapy. All above stated treatments showed clinical beneficial effects, by reducing borderline personality disorder core pathology and associated general psychopathology, as well as by reducing the severity and frequency of self-harm behaviors, and by improving the overall social, interpersonal and global adjustment. Dialectical behavioral therapy and schema-focused therapy also caused a soaring remission rate of diagnostic borderline personality disorder criteria of 57% and 94%, respectively.Discussion: Although there were differences between the psychotherapeutic interventions analysed in this review, all showed clinical benefits in the treatment of borderline personality disorder. Dialectical behavioral therapy and schema-focused therapy presented the strongest scientific data documenting their efficacy, but both interventions are integrative cognitive-behavioral therapies which deviate from the traditional cognitive-behavioral model.Conclusion: In summary, the available studies support cognitive-behavioral psychological treatments as an efficacious intervention in borderline personality disorder. However, the existing scientific literature on this topic is still scarce and there is need for more studies, with higher methodological rigor, that should validate these results.


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