The Beginning Psychotherapist and Borderline Personality Disorder: Basic Treatment Principles and Clinical Foci

Abstract

Borderline personality disorder is a prevalent psychopathology; thus, most graduate students in psychology, residents in psychiatry, and early career clinicians will encounter patients with this disorder in the course of their training or initial professional practice. This paper provides clear and concise guidelines for conducting treatment geared toward the clinician's developmental level. It builds upon the knowledge and skills that are typically acquired during graduate education and training to provide an accessible framework for undertaking psychotherapy with patients who have borderline personality disorder. This paper draws upon common psychotherapeutic factors and existing evidence-based treatments for the disorder to identify principals and interventions that are likely to contribute to therapeutic action. It uses behavioral, cognitive, and psychodynamic interventions to address the patient's multidimensional psychopathology. This approach offers a coherent and integrated treatment framework for the beginning psychotherapy practitioner.

Patient personality characteristics and therapeutic integration: treating borderline personality and emotionally dysregulated-dysphoric personality features

“…Regarding the Borderline Clinical Prototype findings, there have been additional proposals of approaching the treatment of borderline pathology via an integration of cognitive therapy and psychodynamic therapy, through the thoughtful merging of prevailing cognitive (e.g., Beck & Freeman, 1990) and psychodynamic (e.g., Kernberg, Selzer, Koenigsberg, Carr, & Applebaum, 1989) models of BPD treatment (Louw & Straker, 2002). Similar variations of this notion have been proposed, all with the shared root of integration as an ideal treatment approach to BPD (e.g., Links, 2015;Merced, 2015;Paris, 2015). Additionally, a case study with inpatients diagnosed with BPD demonstrated the necessity of a more flexible, and at times more structured, treatment approach with this population (Goodman, Anderson, & Diener, 2014).…”

“…Similar variations of this notion have been proposed, all with the shared root of integration as an ideal treatment approach to BPD ( e.g ., Links, 2015 ; Merced, 2015 ; Paris, 2015 ). Additionally, a case study with inpatients diagnosed with BPD demonstrated the necessity of a more flexible, and at times more structured, treatment approach with this population (Goodman, Anderson, & Diener, 2014 ).…”

Peer-Led Group Tele-Supervision of Clinical Psychologists: Optimization of Resources - A Malaysian Case Study

“…Resistance and countertransference can happen while dealing with complicated cases, including borderline personality disorder 9 . The WhatsApp TM group allows cases to be dissected from different angles and perspectives.…”

Conversational model psychotherapy

“…Where a patient is engaged with the therapist in a medium-to long-term therapy, the therapist will contribute to disjunctions and will need to work on repair, which, if done adequately, is often an opportunity for therapeutic growth. 4,19 CMT, and indeed other psychodynamic psychotherapies, are not 'stand alone' treatments. CMT aims to develop a creative therapeutic relationship.…”

“…Given that disorders such as BPD are common clinically it is important for all mental health professionals to have a grasp of basic therapeutic principles, including approaches to trauma-informed care. 19…”