Psychotherapy for Borderline Personality Disorder: Does the Type of Treatment Make a Difference?
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Personality Disorders (M Zimmerman, Section Editor)
Psychotherapy for Borderline Personality Disorder: Does the Type of Treatment Make a Difference? William D. Ellison, Ph.D. Address Department of Psychology, Trinity University, One Trinity Place, San Antonio, TX, 78212, USA Email: [email protected]
* Springer Nature Switzerland AG 2020
This article is part of the Topical Collection on Personality Disorders Keywords Borderline personality disorder I Psychotherapy I Dialectical behavior therapy I Mentalization-based treatment
Abstract Purpose of Review The first aim of this review is to summarize the major evidence-based psychotherapies for borderline personality disorder (BPD) and the research supporting their use. The second aim is to explore the evidence for the differential effectiveness of these treatments. Recent Findings Four types of specific psychotherapies are identified that show promising results in at least two randomized controlled trials. In addition, several adjunctive and minimal/pragmatic interventions are available that are supported by research evidence. Recent findings highlight the applicability of these treatments across settings and populations and have begun to show that modified versions of them are also beneficial. Summary There is solid evidence that various specific therapies are superior to treatment as usual in the community for borderline personality disorder. There is no reliable evidence that any of these specific treatments is more effective than any other, however. In addition, existing treatments have many elements in common that may be responsible in part for their effects. Future research will be needed to uncover the influence of various study design factors, patient characteristics, and treatment parameters on psychotherapy outcome for BPD.
Personality Disorders (M Zimmerman, Section Editor)
Introduction Borderline personality disorder (BPD) is a relatively severe, impairing, and costly form of mental illness [1– 3]. Studies estimate its prevalence at around 1–2% of the general adult population and 10–12% of psychiatric outpatients, and the disorder is notably common among individuals presenting for medical care in other settings [4]. BPD is also probably underdiagnosed, or misdiagnosed as other disorders, and there remains some degree of stigma towards individuals with the disorder and pessimism about the prospect of successful treatment among clinicians, although this situation may be improving [5–9]. Nonetheless, abundant research now demonstrates the efficacy and effectiveness of several kinds of psychotherapies for BPD. A recent meta-analysis of randomized controlled trials suggested small to moderate effect sizes differentiating BPD-specific treatments from treatment as usual in terms of symptom reduction and amelioration of functioning [10••]. Both dialectical behavior therapy and specialized psychodynamic psychotherapies were superior to control groups in this review. There remained a high degree of heterogeneity between the included studies’ effect sizes, h
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