Interpersonal Psychotherapy Adapted for Borderline Personality Disorder (IPT-BPD): A Review of Available Data and a Proposal of Revision

Abstract

Interpersonal model of psychotherapy integrates both the relational theory of Harry Stack Sullivan [1] and the attachment theory of John Bowlby [2]. Sullivan asserted that "a person can never be isolated from the complex of interpersonal relations in which the person lives and has his being". This idea was influenced by the integrative psychobiological theories of Adolf Meyer [3] and based on the clinical observation of a primary social group and the immediate involvement of the subject with one or more significant persons. Individual personality is defined by the relations that are established and by the social role that the he plays. According to John Bowlby's attachment theory, secure attachment to the caregiver early in life forms the foundation for later success in interpersonal relationships. Interpersonal therapy was designed on the basis of these theories and is focused on the patient's intimate relationships.Interpersonal psychotherapy (IPT) was proposed in 1984 by Klerman and colleagues [4], who defined the methods and techniques of this psychotherapeutic approach for patients with a diagnosis of major depression. Traditional IPT is a time-limited, diagnosis-focused, life-event-based treatment consisting of 12-16 weekly sessions. The intervention has a distinct medical setting based on the formulation and communication of a diagnosis, and on the transitory attribution of the phenomena of illness to the patient. During IPT sessions the intervention is focused on one of four interpersonal problem areas that patient and therapist together identify and choose: grief, interpersonal role disputes, role transitions, and interpersonal deficits. Interpersonal approach removes responsibility from the patient regarding guilt and frustration for their emotional experience and at the same time defines the symptoms in a syndromic context that is known and therefore curable. Adaptation of IPT to Other Psychiatric Disorders: The Case of Borderline Personality DisorderThe efficacy of IPT in treatment of major depression is wellestablished, and recent meta-analyses have confirmed its efficacy in both monotherapy and in association with pharmacotherapy [5,6]. The promising results that this psychotherapeutic intervention has obtained in its primary indication, unipolar major depression, have led clinicians and investigators to enlarge the application of IPT beyond this clinical population. So, IPT has been studied in several psychiatric disorders: dysthymia [7][8][9][10] AbstractInterpersonal psychotherapy (IPT) was developed by Klerman in 1984 for patients with major depression. IPT is aimed to the resolution of interpersonal difficulties, improving both social functioning and psychiatric symptoms. The promising results that this model of psychotherapy has obtained in unipolar depression have led investigators to enlarge the application of IPT beyond this clinical population. Specific adaptations of IPT have been required to address the different psychopathological and clinical characteristics of each disorder. IPT has...

Psychotherapies for borderline personality disorder: a focused systematic review and meta-analysis

“…46 Recently, it has been suggested to complement IPT-BPD with a family intervention aiming to educate significant others about BPD. 47 CBT includes psychoeducation and focuses on restructuring maladaptive core beliefs and patterns of behaviour, and aims to develop new, more adaptive beliefs about the self and others, and more adaptive strategies of behaviour. 48 DDP is a psychodynamic treatment with a strong experiential component that has been developed to specifically meet the needs of individuals with BPD and co-occurring substance use disorder or antisocial personality disorder.…”

Real-World Functioning in Psychiatric Outpatients: Predictive Factors

“…In patients with a diagnosis of MDD or BPD, interpersonal psychotherapy (IPT) was offered. Patients with MDD were treated with traditional IPT lasting 16 weeks [ 74 ], while patients with BPD were treated with the revised adaptation of IPT to BPD (IPT-BPD), lasting 10 months [ 75 ]. Patients with schizophrenia and bipolar disorder were not treated with psychotherapy in our study.…”

Interpersonal Psychotherapy as a Single Treatment for Borderline Personality Disorder: A Pilot Randomized-Controlled Study

“…During the hospitalization IPT-BPD-R continues if the patient's clinical conditions allow it. In our revised model of IPT-BPD is also included an intervention for patients' family members in order to help them to understand and deal with the disorder of their relative (24).…”

“…IPT adapted for BPD derived from the standard model of IPT for major depression (23) modified by Markowitz (17) to address the peculiar features of BPD and to handle the difficulties in interpersonal relationships typical of these patients. Our research group proposed a revision of the IPT-BPD that is indicated as IPT-BPD-R (24).…”