Alternative Treatment For Borderline Personality Disorder

2430 words - 10 pages

(A paper on the BOSCOT Trials--A form of CBT, Dialectical Behavior Therapy vs. Treatment as Usual) Includes Abstract AbstractThis is the outcome of a study in which 106 participants who met the diagnostic criteria for Borderline Personality Disorder, or BPD, were randomized into two groups. The first group, or the control group, received treatment as usual (TAU). The second group received treatment as usual along with a form of cognitive behavioral therapy known as dialectical behavioral therapy. The study was conducted over the course of two years; the first year was for treatment and the second year for follow-up. The primary research hypothesis was that the cognitive behavioral therapy ...view middle of the document...

Borderline personality disorder is placed by the DSM-IV-TR in the cluster of "dramatic" personality disorders (Comer, 2008). This is a disorder of emotion regulation. Borderline personality disorder patients often need long-term mental health inpatient services, and this disorder alone account for 20% of all psychiatric hospitalizations (Davidson, et al, 2006).Treatment for borderline personality disorder can be difficult. Intense psychotherapy appears to have some degree of effectiveness, but it can be difficult for the therapist to find a balance in the relationship. Constantly dealing with outbursts of anger and fluctuating emotional states, while attempting to build a trusting, working relationship, can make therapy extremely difficult (Comer, 2008). Borderline patients are known to often violate therapeutic boundaries, such as calling the emergency number for non-emergency situations, just for the attention (Comer, 2008).With less than 2% of the population using 20% of the psychiatric services, through no fault of their own. How can these people be helped? The answer seems to lie in Cognitive Behavioral Therapy, or CBT, a psychotherapeutic approach that aims to influence problematic and dysfunctional emotions, behaviors and thoughts, through goal-oriented, systematic procedures. This is a direct, collaborative, and problem-focused therapy which concentrates on the "here and now," as well as symptom removal (NIMH, 2008).A form of cognitive behavioral therapy that, according to M. Linehan (1991), has been especially helpful with the treatment of borderline personality disorder is called dialectical behavioral therapy, or DBT. This approach is an action oriented, collaborative approach which teaches clients to explore, identify, analyze, and change dysfunctional patterns of thinking, feeling, and acting (Dewan, et al, 2004). This approach is considered a form of "brief therapy", meaning it can be accomplished in a very short time frame, as opposed to long-term psychotherapy.Borderline personality disorder patients are not easy populations with which to work, and do not always respond well to treatment. This form of cognitive behavioral therapy, dialectical behavioral therapy, when added to treatment as usual, may be extremely helpful to these patients, thus improving their self awareness, by enhancing their sense of self and thereby reducing acts of deliberate self-harm and suicide attempts.MethodBetween 2002 and 2005, 106 participants who had been previously diagnosed with borderline personality disorder, according to Axis II of the DSM-IV-TR, "were randomized to two treatment conditions, either treatment as usual alone (TAU), or cognitive behavioral therapy, in addition to treatment as usual (CBT plus TAU) (Davidson, et al, 2006). The type of cognitive behavioral therapy received was described in the introduction to this paper. It is known as dialectical behavioral therapy. Treatment as usual (TAU) included general practitioner care; contact...

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