BORDERLINE PERSONALITY DISORDER

Analysis of dialectical behavioral therapy for self-harm in

Women with borderline personality disorder

Table of Contents

Ch # 13

Introduction3

Background3

Reason for choosing which is from personal perspective4

Patient benefit4

Aim of Project5

Ch # 26

Literature Review6

Key Concepts8

Borderline Personality Disorder8

Examine Current Nursing Practices9

Dialectical Behaviour Therapy11

Therapist Characteristics in DBT12

Ch # 314

Methodology14

Ch # 417

Discussion17

Potential Relevant Issues17

Patients' and Therapists' Agreements20

Modes of Treatment22

Skills Training23

Stages of Therapy and Treatment Targets25

Treatment Strategies28

Ch # 531

Conclusion31

Empirical Evidence31

Limitation of Study34

Summary and Conclusions35

References37

Ch # 1

Introduction

Dialectical Behaviour Therapy is based on a bio-social theory of borderline personality disorder. Linehan hypothesises that the disorder is a consequence of an emotionally vulnerable individual growing up within a particular set of environmental circumstances which she refers to as the 'Invalidating Environment'.

An 'emotionally vulnerable' person in this sense is someone whose autonomic nervous system reacts excessively to relatively low levels of stress and takes longer than normal to return to baseline once the stress is removed(Harned, Melanie, 2008). It is proposed that this is the consequence of a biological diathesis.

Background

Nee Farman (2005) described Dialectical Behaviour Therapy (DBT) as, 'since 1987, the single most remarkable entry in the therapeutic strategies for Borderline Personality Disorder (BPD). BPD, a heterogeneous condition with significant differences in individual symptom patterns, has a 10% mortality rate due to suicide. No wonder that mental health staff describe individuals diagnosed with BPD as the most challenging and difficult patients encountered in their practice (Harned, Melanie, 2008).

We survey the experiences and expectations of mental health staff with patients having a diagnosis of BPD and, their perspective on treatments with particular reference to DBT.

Reason for choosing which is from personal perspective

Borderline personality disorder is characterised by a consistent pattern of instability in controlling feelings, deficiency in controlling impulses, problems with relationships, and poor self-esteem. In a clinical context, the disorder is expressed as difficulties in managing ones feelings, impulsive actions and aggressiveness, repeated episodes of self-inflicted injury, and suicide attempts. Patients with borderline personality disorder often have other personality disorders or diseases, eg, depression, eating disorders, drug abuse, or anxiety problems.

Patient benefit

Six randomised controlled trials compared DBT to other psychiatric treatment. A large percentage of women were included in these trials. The duration of treatment was usually 1 year, and the outcomes varied by study, partly because different subgroups were studied. The results show that DBT leads to a reduction in self-injurious behavior and fewer dropouts from treatment.

Aim of Project

Dialectical Behaviour Therapy is an innovative method of treatment that has been developed specifically to treat this difficult group of patients in a way which is optimistic and which preserves the morale of the therapist (Harned, Melanie, 2008).

The technique has been devised by Marsha Linehan at the University of Washington in Seattle and its effectiveness has been demonstrated in a controlled study, the results of which will be summarised later in this paper.

Ch # 2

Literature Review

According to the Journal of consulting and clinical psychology, vol 76, the study evaluated whether dialectical behavior therapy (DBT) was more efficacious than treatment by nonbehavioral psychotherapy experts in reducing co-occurring Axis I disorders among suicidal ...