2018
DOI: 10.1521/pedi.2018.32.supp.115
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Alliance Rupture and Resolution in Dialectical Behavior Therapy for Borderline Personality Disorder

Abstract: The aim of this exploratory study was to investigate alliance rupture and resolution processes in the early sessions of a sample of clients who underwent 1 year of standard dialectical behavior therapy (DBT) for borderline personality disorder (BPD). Participants were three recovered and three unrecovered clients drawn from the DBT arm of a randomized controlled trial that compared the clinical and cost-effectiveness of DBT and general psychiatric management. Alliance rupture and resolution processes were code… Show more

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Cited by 47 publications
(51 citation statements)
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“…This finding thus supports the advancement towards an integrative view of effectiveness of psychotherapy for BPD (Bateman, Gunderson, & Mulder, 2015). The study highlights the potentially common mechanisms of change which may have been previously overlooked due to a focus on theory-consistent conceptualizations in process and outcome research Several candidates for such common, that means, transtheoretical mechanisms have been proposed, for instance mentalizing (Bateman, Campbell, Luyten, & Fonagy, 2017;DEFENSE MECHANISMS IN DIALECTICAL-BEHAVIOR THERAPY 15 Fischer-Kern et al, 2015), therapist's responsiveness (Kramer, 2017a), and rupture-repair episodes in the therapeutic alliance (Boritz, Barnhart, Eubanks, & McMain, 2018). Utilizing such transtheoretical concepts in studies of BPD treatments might be useful towards explaining currently unexplained variance related to partial response and dropout.…”
Section: Discussionmentioning
confidence: 96%
“…This finding thus supports the advancement towards an integrative view of effectiveness of psychotherapy for BPD (Bateman, Gunderson, & Mulder, 2015). The study highlights the potentially common mechanisms of change which may have been previously overlooked due to a focus on theory-consistent conceptualizations in process and outcome research Several candidates for such common, that means, transtheoretical mechanisms have been proposed, for instance mentalizing (Bateman, Campbell, Luyten, & Fonagy, 2017;DEFENSE MECHANISMS IN DIALECTICAL-BEHAVIOR THERAPY 15 Fischer-Kern et al, 2015), therapist's responsiveness (Kramer, 2017a), and rupture-repair episodes in the therapeutic alliance (Boritz, Barnhart, Eubanks, & McMain, 2018). Utilizing such transtheoretical concepts in studies of BPD treatments might be useful towards explaining currently unexplained variance related to partial response and dropout.…”
Section: Discussionmentioning
confidence: 96%
“…Contudo, o padrão é consistente com os demais indicadores evidenciados (faltas e atrasos). Não se pode também desconsiderar que se trata de uma psicoterapia interrompida (malsucedida) com paciente TPB, supostamente mais propenso a demonstrarem dificuldades no estabelecimento e manutenção da AT (Boritz, Barnhart, Eubanks, & McMain, 2018;Safran et al, 2009). O estudo de Doran, Safran e Muran (2017), que examinou a relação entre o processo terapêutico e a negociação da AT de 47 pacientes com diferentes psicopatologias clínicas (ansiedade e depressão) e com transtorno de personalidade (48,9%), também destacou flutuação na ocorrência das rupturas (confrontação e evitação) ao longo do tempo.…”
Section: Discussionunclassified
“…Tal achado sugere que o paciente apresente dificuldade de expressar sua insatisfação ou angústia, de maneira direta. Conforme a literatura, a frequência de rupturas de evitação é significativamente maior em pacientes que abandonaram o tratamento (Boritz et al, 2018). Tais rupturas, em comparação com as de confrontação, são mais difíceis de identificar, pois o comportamento do paciente, ao evitar o trabalho terapêutico ou a terapeuta é sutil, pouco claro ou até mesmo obscurecido (Safran et al, 2011).…”
Section: Discussionunclassified
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