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Borderline personality disorder : A case for the right treatment, at the right dose, at the right time
Campbell, Katrina Lakeman, Richard
Campbell, Katrina
Lakeman, Richard
Abstract
There is now compelling evidence that a range of psychotherapeutic treatments are effective in the treatment of borderline personality disorder (BPD). Such treatments are often lengthy, expensive, subject to high rates of incompletion and are rarely available to people with sub-threshold symptoms. There is broad agreement that some combination of vulnerability, invalidating environment, childhood adversity, disrupted attachment in childhood or trauma play a role in the aetiology of the syndrome of BPD. These factors also contribute to problems with the capacity to mentalise, regulate emotions, tolerate distress and impact on psychosocial development with or without self-damaging and suicidal behaviour. This column takes as a given that people with BPD should receive evidence-based psychological treatments such as dialectical behaviour therapy (DBT), interpersonal therapy and cognitive behavioural therapy in a sufficient dose to be helpful. However, to avert an escalating trajectory which may lead to a diagnosis of BPD the right dose of the right therapy at the right time is necessary. Under-dosing or ineffective psychotherapy can be potentially harmful. This column reviews the evidence, such as it is, for therapeutic approaches which may contribute to more skilful negotiation of life’s difficulties and which may avert deterioration in mental health and quality of life in vulnerable individuals and families.
Keywords
Date
2021
Type
Journal article
Journal
Issues in Mental Health Nursing
Book
Volume
42
Issue
6
Page Range
608-613
Article Number
ACU Department
School of Education
Faculty of Education and Arts
Faculty of Education and Arts
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Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled