Treatment

DIAGNOSIS: Borderline Personality Disorder

TREATMENT: Dialectical Behavioral Group Therapy (DBT) for Borderline Personality Disorder

BRIEF SUMMARY

  • Basic premise: A subset of individuals experience emotions more intensely than others. In order to regulate heightened emotions, they tend to react in a more extreme and impulsive manner (e.g., self-harm, suicide attempts). It is thought that a lack of awareness and acceptance of these emotional experiences interferes with developing more effective coping strategies for distress.
  • Essence of therapy: Dialectical behavior therapy teaches clients behavioral skills in mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation.

TREATMENT RESOURCES

TREATMENT MANUALS

Cognitive-behavioral treatment of borderline personality disorder. (Linehan, M. M.)

Skills training manual for treating borderline personality disorder. (Linehan, M. M.)

DBT skills training manual (Linehan, M. M.)

WORKBOOKS and WORKSHEETS

DBT skill training handouts and worksheets (Linehan, M. M.)

Borderline: Retrouver son équilibre. (Page, D.)

ADDITIONAL RESOURCES

Behavioral tech. (BehavioralTech.org)

SUPPORTING STUDIES

Bianchini, V, Cofini, V, Curto, M, Lagrotteria, B., Manzi, A., Navari, S., Ortenzi, R., Paoletti, G., Pompili, E., Pompili, P. M., Silvestrini, C., & Nicolò, G. (2019). Dialectical behaviour therapy (DBT) for forensic psychiatric patients: An Italian pilot study. Criminal Behaviour and Mental Health, 29(2), 122–130.

https://doi.org/10.1002/cbm.2102

Carter, G. L., Willcox, C. H., Lewin, T. J., Conrad, A. M., & Bendit, N. (2010). Hunter DBT project: Randomized controlled trial of dialectical behaviour therapy in women with borderline personality disorder. Australian and New Zealand Journal of Psychiatry, 44(2), 162–173.

https://doi.org/10.3109/00048670903393621

Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2007). Evaluating three treatments for borderline personality disorder: A multiwave study. The American Journal of Psychiatry, 164(6), 922–928.

https://doi.org/10.1176/ajp.2007.164.6.922

Dixon-Gordon, K. L., Chapman, A. L., & Turner, B. J. (2015). A preliminary pilot study comparing dialectical behavior therapy emotion regulation skills with interpersonal effectiveness skills and a control group treatment. Journal of Experimental Psychopathology, 6(4), 369 –388.

https://doi.org/10.5127/jep.041714

Feigenbaum, J. D., Fonagy, P., Pilling, S., Jones, A., Wildgoose, A., &

Bebbington, P. E. (2012). A real-world study of the effectiveness of

DBT in the UK National Health Service. British Journal of Clinical

Psychology, 51(2), 121–141.

https://doi.org/10.1111/j.2044-8260.2011.02017.x

Koons, C. R., Robins, C. J., Tweed, J. L., Lynch, T. R., Gonzalez, A. M., Morse, J. Q., Bishop, G. K, Butterfield, M. I., & Bastian, L. (2001). Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behavior Therapy, 32(2), 371–390.

https://doi.org/10.1016/S0005-7894(01)80009-5

Kramer, U., Pascual-Leone, A., Berthoud, L., de Roten, Y., Marquet, P., Kolly, S., Despland, J. -N., Page, D. (2016). Assertive anger mediates effects of dialectical behaviour-informed skills training for borderline personality disorder: A randomized controlled trial. Clinical Psychology and Psychotherapy, 23(3), 189–202.

https://doi.org/10.1002/cpp.1956

Linehan, M. M., Armstrong, H. E., Suarez, A., Allmon, D., & Heard, H. L. (1991). Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48(12), 1060–1064.

https://doi.org/10.1001/archpsyc.1991.01810360024003

Linehan, M. M., Schmidt, H., III., Dimeff, L. A., Craft, J. C., Kanter, J., & Comtois, K. A. (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. The American Journal on Addictions, 8(4), 279–292. 

https://doi.org/10.1080/105504999305686

Linehan, M. M., Dimeff, L. A., Reynolds, S. K., Comtois, K. A., Welch, S. S., Heagerty, P., & Kivlahan, D. R. (2002). Dialectical behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug and Alcohol Dependence, 67(1), 13–26.

https://doi.org/10.1016/S0376-8716(02)00011-X

Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., Korslund, K. E., Tutek, D. A., Reynolds, S. K., Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63(7), 757–766.

https://doi.org/doi:10.1001/archpsyc.63.7.757

Lin, T. -J., Ko, H. -C., Wu, J. Y. -W., Oei, T. P., Lane, H. -Y., & Chen, C. -H. (2019) The effectiveness of dialectical behavior therapy skills training group vs. cognitive therapy group on reducing depression and suicide attempts for borderline personality disorder in Taiwan. Archives of Suicide Research, 23(1), 82–99.

https://doi.org/10.1080/13811118.2018.1436104

McMain, S. F., Links, P. S., Gnam, W. H., Guimond, T., Cardish, R. J., Korman, L., & Streiner, D. L. (2009). A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder. The American Journal of Psychiatry, 166(12), 1365–1374.

https://doi.org/10.1176/appi.ajp.2009.09010039

McMain, S. F., Guimond, T., Barnhart, R., Habinski, L., & Streiner, D. L. (2017). A randomized trial of brief dialectical behaviour therapy skills training in suicidal patients suffering from borderline disorder. Acta Psychiatrica Scandinavica, 135(2), 138–148.

https://doi.org/10.1111/acps.12664

Pistorello, J., Fruzzetti, A. E., Maclane, C., Gallop, R., & Iverson, K. M. (2012). Dialectical behavior therapy (DBT) applied to college students: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 80(6), 982–994.

https://doi.org/10.1037/a0029096

Priebe, S., Bhatti, N., Barnicot, K., Bremner, S., Gaglia, A., Katsakou, C., Molosankwe, I., McCrone, P., & Zinkler, M. (2012). Effectiveness and cost-effectiveness of dialectical behaviour therapy for self-harming patients with personality disorder: A pragmatic randomised controlled trial. Psychotherapy and Psychosomatics, 81(6), 356–365.

https://doi.org/10.1159/000338897

Soler, J., Pascual, J. C., Tiana, T., Cebrià, A., Barrachina, J., Campins, M. J., Gich, I., Alvarez, E., & Pérez, V. (2009). Dialectical behaviour therapy skills training compared to standard group therapy in borderline personality disorder: A 3-month randomised controlled clinical trial. Behaviour Research and Therapy, 47(5), 353–358.

https://doi.org/10.1016/j.brat.2009.01.013

Verheul, R., Van Den Bosch, L. M. C., Koeter, M. W. J., De Ridder, M. A. J., Stijnen, T., & Van Den Brink, W. (2003). Dialectical behaviour therapy for women with borderline personality disorder: 12-month, randomised clinical trial in the Netherlands. The British Journal of Psychiatry, 182, 135–140.

https://doi.org/10.1192/bjp.182.2.135