Interventions

There are a range of mental health interventions and psychological therapies available for Personality Disorder.

These include:

Cognitive Analytical Therapy

  • Postulates that a set of partially dissociated ‘self-states’ account for the clinical features of
  • borderline personality disorder
  • Rapid switching between these self-states leads to dyscontrol of emotions including intense expression and virtual absence (depersonalisation)
  • Therapy aims to formulate these processes collaboratively,examining them as they occur in treatment as well as in life experiences

Cognitive Therapy

  • This is a modification of standard cognitive and behaviour therapy that is goal directed and focused more on altering underlying belief structures rather than reduction of symptoms
  • It is likely to take up to 30 sessions of treatment of which the initial ones help to define the areas of intervention by identifying what are the fundamental structures of past, present and future experiences
  • The therapist and patient maintain a collaborative therapeutic alliance throughout treatment and include homework and testing of core beliefs and structures

Dialectic Behaviour Therapy (DBT)

  • This is a special adaptation of cognitive therapy, originally used for the treatment of women with borderline personality disorder who harmed themselves repeatedly
  • DBT is a manualised therapy including functional analysis of behaviour, skills training and support (empathy, validation of feelings, management of trauma)
  • Directed at reducing self-harm

Dynamic psychotherapy

  • This is based on a developmental model of personality
  • Treatment is generally long term
  • The aim of therapy is to understand the way in which the past influences the present with the use of interpretation
  • Treatment focuses on the therapeutic alliance between patient and therapist, the individual’s emotional life, and defences
  • Therapy uses the relationship between patient and therapist (transference) as a way to understand how the internal world of the individual affects relationships

Mentalisation Based Therapy (MBT)

  • A mixed group and individual therapy based on psychoanalytic principles
  • Treatment typically lasts 18 months
  • Directed towards developing the ability to mentalise, that is to interpret the actions of oneself and others as meaningful on the basis of intentional mental states (e.g., desires, needs, feelings, beliefs, & reasons)

Therapeutic Community Treatments

  • Therapeutic communities provide intensive psychosocial treatment which may include a variety of therapies but where the therapeutic environment itself is seen as the primary agent of change
  • They include democratic and concept types, the former including members of the community as decision makers
  • External control is kept to a minimum: members of the community take a significant role in decision making and the everyday running of the unit