Common Factors in Empirically Supported Treatments of Borderline Personality Disorder

Abstract

In this article, we examine the manuals of empirically supported psychotherapies for borderline personality disorder (BPD) by comparing their common and specific treatment strategies. We compare these treatments using a previously constructed scale of treatment interventions. Individual psychotherapies for BPD have several common strategies: clear treatment framework, attention to affect, focus on treatment relationship, an active therapist, and exploratory and change-oriented interventions. Use of interpretations, supportive interventions, designating treatment targets, attention to patient functioning, multimodal treatment, and support for therapies varied across the psychotherapies. We discuss these findings in the context of clusters of BPD symptoms, reports regarding overlap in treatment interventions used by various psychotherapies, and the effectiveness of specific treatment strategies.

Assessment and Treatment of Patients with Borderline Personality Disorder in the College and University Population

“…In these cases, the goal should be to refer a student, if possible, to a clinician practicing one of the empirically supported psychotherapies, including DBT, mentalization-based therapy (MBT), schema-focused therapy (SFT), general psychiatric management (GPM), transference-focused therapy (TFP), or systems training for emotional predictability and problem solving (STEPPS). All these treatments have common strategies including: clear treatment framework, attention to the patient's affective state, focus on the treatment relationship, an active therapist, and exploratory and change-oriented interventions (Weinberg et al, 2011). Indeed, some authorities have suggested that the empirically-based treatments for BPD have more similarities than differences (Paris, 2010).…”

Fra krisemaksimering til kriseminimalisering

“…Forskning viser at behandling uten definerte rammer og varighet resulterer i at 67 % av pasientene med emosjonelt ustabil personlighetsforstyrrelse falt ut av behandlingen kort tid etter oppstart. Stort fokus på struktur og klare rammebetingelser er således viktige forutsetninger for å arbeide med denne pasientgruppen (Derksen, Benders & Roverts 1998, Weinberg, Ronningstam, Goldblatt, Schechter, Maltsberger, 2011.…”

Management of borderline personality disorder

“…This suggests that common factors explain part of the efficacy of treatment, with structure being particularly important. 21 A clearer understanding of what parts of these complex interventions are most important may lead to refinements of treatment and potential cost savings. The most recent Cochrane review of psychotherapy for borderline personality disorder, although it included only studies published to 2003, found support for dialectical behaviour therapy and mentalization-based treatment, 22 and recent findings strengthen this conclusion.…”