Factors predicting the outcome of psychotherapy for borderline personality disorder: A systematic review

Barnicot, Kirsten; Katsakou, Christina; Bhatti, Nyla; Savill, Mark; Fearns, Naomi; Priebe, Stefan

doi:10.1016/j.cpr.2012.04.004

Cited by 109 publications

(93 citation statements)

References 63 publications

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“…Among participants, patient 3 reported no symptoms associated with BPD at the end of the treatment and met no BPD criteria based on SCHID-II; this improvement was maintained on the follow-up. As it seems that patients responded honestly to questionnaires, a good therapeutic alliance and the absence of dissociative symptoms and childhood traumatic experiences may influence treatment outcomes, as Kleindienst et al and Barnicot et al also cited them as good prognostic factors in BPD treatment (33,34). Also, contrary to some researchers, who believe that male gender predicts poor treatment outcomes, the male patient in the present research experienced the greatest improvement.…”

Section: Discussioncontrasting

confidence: 54%

The Applicability and Efficacy of Transdiagnostic Cognitive Behavior Therapy on Reducing Signs and Symptoms of Borderline Personality Disorder With Co-Occurring Emotional Disorders: A Pilot Study

Mohammadi

Bakhtiari

Arani

et al. 2018

Iran J Psychiatry Behav Sci

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Background: Borderline personality disorder (BPD), which is highlighted by emotional dysregulation and high rates of comorbid emotional disorders, is one of the most challenging clinical conditions for mental health services in different communities. The Unified protocol for the transdiagnostic treatment of emotional disorders (UP) was designed to target common vulnerabilities across emotional co-occurring disorders. Objectives: The aim of the present study was to examine the preliminary efficacy of the UP in treatment of Iranian patients with BPD and comorbid emotional disorders. Methods: By the purposeful sampling method, 6 participants (5 females and 1 male) with borderline personality disorder (BPD) and major depressive disorder (MDD), which met the inclusion criteria, participated in a multiple baseline experimental single case study. Each participant completed the borderline personality inventory (BPI) and difficulties in emotion regulation scale (DERS) during 3 baseline, 8 treatment modules, and 1 follow up assessment session. The unified protocol was carried out for 16 to 20 weekly sessions. Optical analysis and reliable change index (RCI) were used for determination of statistical significance. Remission rate was also applied to measure clinical significance. Results: Results showed that the unified protocol (UP) was effective on reduction of BPD and depressive symptoms as well as increase of emotion regulation skills. Conclusions: The efficacy of UP was statistically and clinically significant in most of the participants. Results from this study provide preliminary evidence for the efficacy of the UP in the treatment of BPD with co-occurring unipolar depressive disorders in Iran, and provide additional support for the transdiagnostic approach in the treatment of emotional disorders.

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Section: Discussioncontrasting

confidence: 54%

The Applicability and Efficacy of Transdiagnostic Cognitive Behavior Therapy on Reducing Signs and Symptoms of Borderline Personality Disorder With Co-Occurring Emotional Disorders: A Pilot Study

Mohammadi

Bakhtiari

Arani

et al. 2018

Iran J Psychiatry Behav Sci

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“…Although this impairment is pervasive and arises across situations and relationships, it is of central importance as it manifests clinically. For example, it is evident in the counter-therapeutic behaviors of personality disordered patients (Anchin & Pincus, 2010; Maltsberger & Buie, 1974; Strauss et al, 2006), which contribute to the pessimistic attitudes of professional psychiatric staff (Bowers & Allan, 2006, p. 241), and in turn negatively impact the effective delivery of psychiatric treatments (Barber, Connolly, Crits-Cristoph, Gladis, & Siqueland, 2009; Barnicot et al, 2012; Hilsenroth, Holdwick, Castlebury, & Blais, 1998; Kuyken et al, 2001; Reich & Green, 1991; Shea et al, 1990; Saxon & Barkham, 2012; Safran & Muran, 1996). …”

Section: An Interpersonal Approach To Defining Personality Pathologymentioning

confidence: 99%

The Interpersonal Core of Personality Pathology

Hopwood¹,

Wright

Ansell³

et al. 2013

Journal of Personality Disorders

228

213

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The purpose of this paper is to demonstrate that personality pathology is, at its core, fundamentally interpersonal. We review the proposed DSM-5 Section 3 redefinition of personality pathology involving self and interpersonal dysfunction, which we regard as a substantial improvement over the DSM-IV (and DSM-5 Section 2) definition. We note similarities between the proposed scheme and contemporary interpersonal theory and interpret the DSM-5 Section 3 definition using the underlying assumptions and evidence base of the interpersonal paradigm in clinical psychology. We describe how grounding the proposed DSM-5 Section 3 definition in interpersonal theory, and in particular a focus on the “interpersonal situation”, adds to its theoretical texture, empirical support, and clinical utility. We provide a clinical example that demonstrates the ability of contemporary interpersonal theory to augment the DSM-5 definition of personality pathology. We conclude with directions for further research that could clarify the core of personality pathology, and how interpersonal theory can inform research aimed at enhancing the DSM-5 Section 3 proposal and ultimately justify its migration to DSM-5 Section 2.

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“…Research on therapeutic alliances has emerged predominantly from long-term data in the field of psychotherapy (e.g. Barnicot et al, 2012;Hersoug, Høglend, Havik, von der Lippe, & Monsen, 2009;Langhoff, Baer, Zubraegel, & Linden, 2008;Munder, 2010). Through analysing the experiences of eight counsellors and their observations of clients' alliance signals, this study identified specific issues that can emerge in short-term counselling.…”

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confidence: 99%

Therapists’ experiences of alliance formation in short-term counselling

Pearson

Bulsara

2016

European Journal of Psychotherapy & Counselling

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While therapeutic alliance formation has been widely researched over many sessions of psychotherapy, the question of alliance formation in short-term counselling has been less explored. Given the increasing evidence in the literature for the positive impact of alliances on therapy outcomes, providing counsellors -who may work with clients for a limited number of sessionswith enhanced insight into alliance formation will be of value. This qualitative study investigated the experiences of eight counsellors forming alliances with clients over short periods. Semi-structured interviews were analysed using interpretive phenomenological analysis. Five major themes emerged, that while congruent with the alliance literature, add some details relevant to day-to-day practice. These themes included: the importance of strong alliances; the need for psychologically comfortable environments; the timing of alliance formation; and the impact of counsellor personal qualities -such as being realin strengthening and maintaining alliances. In addition, an unexpected sixth theme revealed that body language was highly valued as an indicator of strong or weak alliances. Implications for increasing the use of body language to enhance counselling practice and education are discussed. Body language, Counselling, Phenomenology, Therapeutic alliance, Rapport. 3 Therapists' experiences of alliance formation in short-term counselling. KEY WORDS:The therapeutic alliance concept evolved throughout the development of Western psychotherapy, first appearing in 1912 in Freud's early work (Elvins & Green, 2008).Alliances have been defined as "the collaborative and affective bond between therapist and patient" (Daniel, Garske, & Davis, 2000) and "the degree to which the patient experiences the relationship with the therapist as helpful or potentially helpful in achieving the patient's goals in psychotherapy" (Luborsky & Luborsky, 2006, p. 63). Over many decades the influences on, and the value of, strong working alliances in the context of long-term psychotherapy have For example, counsellors working in social support agencies often find clients attending once, twice or even three times, whereas psychotherapists may be accustomed to clients attending for one or more years. Research on therapeutic alliances has emerged predominantly from long-term data in the field of psychotherapy (e.g. Barnicot et al., 2012;Hersoug, Høglend, Havik, von der Lippe, & Monsen, 2009;Langhoff, Baer, Zubraegel, & Linden, 2008;Munder, 2010). Through analysing the experiences of eight counsellors and their observations of clients' alliance signals, this study identified specific issues that can emerge in short-term counselling. Counselling and therapeutic alliancesIt is generally considered conclusive that counselling is effective (e.g. Lambert, 2004;Rosenthal, 1990). An influential factor contributing to this effectiveness is the strength or depth of the counsellor-client relationship. Reviewers of the research are "virtually unanimous in their opinion that the...

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Factors predicting the outcome of psychotherapy for borderline personality disorder: A systematic review

Cited by 109 publications

References 63 publications

The Applicability and Efficacy of Transdiagnostic Cognitive Behavior Therapy on Reducing Signs and Symptoms of Borderline Personality Disorder With Co-Occurring Emotional Disorders: A Pilot Study

The Applicability and Efficacy of Transdiagnostic Cognitive Behavior Therapy on Reducing Signs and Symptoms of Borderline Personality Disorder With Co-Occurring Emotional Disorders: A Pilot Study

The Interpersonal Core of Personality Pathology

Therapists’ experiences of alliance formation in short-term counselling

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