Using Psychotherapy for BPD

Dialectical behavior therapy (DBT), developed by Marcia Linehan, Ph.D., is a cognitive-behavioral treatment program that targets suicidal behavior and other dangerous, severe, or destabilizing behaviors. Standard DBT addresses the following five functions: (1) increasing behavioral capabilities, (2) improving motivation for skillful behavior (through contingency management and reduction of interfering emotions and cognitions), (3) assuring generalization of gains to the natural environment, (4) structuring the treatment environment so that it reinforces functional rather than dysfunctional behaviors, and (5) enhancing therapist capabilities and motivation to treat patients effectively.

("Two-Year Randomized Controlled Trial and Follow-up of Dialectical Behavior Therapy vs. Therapy by Experts for Suicidal Behaviors and Borderline Personality Disorder," <http://archpsyc.ama-assn.org/cgi/content/full/63/7/757>)

Transference-based psychotherapy, developed by Otto Kernberg, M.D., focuses on interpretation of the transference, in the here and now, as an agent of behavior change. The primary focus is on the dominant affect-laden themes that emerge in the relationship between patient and therapist.

("Evaluating Three Treatments for Borderline Personality Disorder: A Multiwave Study," <http://ajp.psychiatryonline.org/cgi/content/abstract/164/6/922>)

Supportive psychotherapy, uses such techniques as sympathetic listening, education, encouragement, limit setting, exhortation (to do or to refrain from certain behaviors), reassurance, advice, and validation.

("Evaluating Three Treatments for Borderline Personality Disorder: A Multiwave Study," <http://ajp.psychiatryonline.org/cgi/content/abstract/164/6/922>)

Mentalization-based therapy, pioneered by Andrew Bateman, M.A., and Peter Fonagy, Ph.D., seeks to facilitate the capacity for "mentalization"—the ability to perceive the mind of others as distinct from one's own and hence to reconsider and reassess one's own perceptions of reality.

("Eight-Year Follow-Up of Treatment for Borderline Personality Disorder: Mentalization-Based Treatment Versus Treatment as Usual," <http://ajp.psychiatryonline.org/cgi/reprint/appi.ajp.2007.07040636v1>)

Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a manual-based group-treatment program for outpatients with three main components: psychoeducation about borderline personality disorder, emotion management skills training, and behavior management skills training.

("Systems Training for Emotional Predictability and Problem Solving (STEPPS) for Outpatients With Borderline Personality Disorder: A Randomized Controlled Trial and 1-Year Follow-Up," <http://ajp.psychiatryonline.org/cgi/content/full/165/4/468>)

Schema-focused therapy combines elements of cognitive-behavioral therapy and psychodynamic and other therapies. Jeffrey Young, Ph.D., who developed the therapy, described it "as an active, structured therapy for assessing and changing deep-rooted psychological problems by looking at repetitive life patterns and core life themes, called ‘schemas.’"

("Outpatient Psychotherapy for Borderline Personality Disorder: Randomized Trial of Schema-Focused Therapy vs. Transference-Focused Psychotherapy,"<http://archpsyc.ama-assn.org/cgi/content/full/63/6/649>)

General psychiatric management is a therapy based on the APA Practice Guideline for the Treatment of Patients With Borderline Personality Disorder consisting of case management, dynamically informed psychotherapy, and symptom-targeted medication management.

("A Randomized Trial of Dialectical Behavior Therapy Versus General Psychiatric Management for Borderline Personality Disorder," <http://ajp.psychiatryonline.org/cgi/content/full/166/12/1365>)