Background and Aims Based on the frequently noted heterogeneity in symptom representation and treatment resistance amongst clients with borderline personality disorder (BPD), this study sought to investigate whether a sample of 77 people with severe personality disorder, primarily BPD (n = 74), could be grouped into clinically meaningful subtypes. A follow‐up question was whether the subtypes would respond differently to a specialist intervention. Method Participants were public mental health clients referred to a specialist residential treatment programme in Victoria, Australia. Using an existing data set, cluster analysis was applied in order to identify subtypes based on various demographic, clinical and psychological variables. Post‐treatment analyses were carried out to investigate change in self‐harm, suicide attempts, depression and dissociation. Results Three subtypes were identified, namely: withdrawn–internalizing, severely disturbed–internalizing and anxious–externalizing. Furthermore, the subtypes responded differently to the treatment, with the withdrawn–internalizing subtype showing reduced levels of dissociation and the anxious–externalizing subtype responding by large reductions in levels of depression. The severely disturbed–internalizing subtype did not improve significantly on any of the outcome measures in this study. Discussion These findings suggest that subtypes can be identified amongst clients with BPD, and that the subtypes may be related to treatment outcomes. Copyright © 2009 John Wiley & Sons, Ltd.

This article reports four case studies illustrating the implementation of the ChooseHealthProgram, a cognitive behavioural lifestyle intervention for overweight and obese adolescents. Participants were an overweight (12 years) and obese (15 years) female, and an overweight (14 years) and obese (12 years) male. The program was delivered by provisional psychologists with program specific training and supervision. All participants demonstrated improvements in body composition, and maintained or improved dietary quality and psychosocial wellbeing. The program had variable effects on physical activity and minimal effect on cardiovascular fitness for three of the four participants. While parents and adolescents required considerable assistance to develop and monitor long term program goals, these goals were a useful clinical tool to support the adolescent and parent to recognise the improvements they had made. Identification and monitoring of specific, measurable, and realistic behaviour change strategies was particularly important in assisting adolescents and their parents to translate session information into improved health behaviours. Results indicate that an adolescent overweight and obesity treatment program that promotes adolescent responsibility and autonomy, and emphasises the importance of parent support and family change is both effective and highly acceptable to both adolescents and parents.