Cognitive Therapy versus Rogerian Supportive Therapy in Borderline Personality Disorder

Jean A. Cottraux · Ivan Druon Note · Florent Boutitie · Maud Milliery · Virginie Genouihlac · Saï Nan Yao +8 more

99 citations0/0 files storedPsychotherapy and Psychosomatics

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Personality Disorders and Psychopathology Psychotherapy Techniques and Applications Bipolar Disorder and Treatment

Abstract

BACKGROUND: To date, there have been no studies comparing cognitive therapy (CT) with Rogerian supportive therapy (RST) in borderline personality disorder. METHOD: Sixty-five DSM-IV borderline personality disorder outpatients were recruited at 2 centres: Lyon and Marseille. Thirty-three patients were randomly allocated to CT and 32 to RST. The therapists were the same in both groups. Both treatments shared the same duration (1 year) and amount of therapy. Assessment by independent evaluators utilised the Clinical Global Impression (CGI) Scale, the Hamilton Depression Scale, Beck Depression Inventory, Beck Anxiety Inventory, Hopelessness Scale, Young Schema Questionnaire II, Eysenck Impulsivity Venturesomeness Empathy (IVE) Inventory, a self-harming behaviours checklist and scales measuring quality of life and the therapeutic relationship. The response criterion was a score of 3 or less on the CGI, associated with a Hopelessness Scale score of <8. RESULTS: No patient committed suicide during the trial. Fifty-one patients were evaluated at week 24, 38 at week 52 and 21 at week 104. Cognitive therapy retained the patients in therapy for a longer time. The response criterion found no significant between-group differences at any measurement point in the completers. However, at week 24, CT was better than RST on the Hopelessness Scale, IVE scale and regarding the therapeutic relationship. At week 104, the CGI improvement (patient and evaluator) was significantly better in CT than in RST. High baseline depression and impulsivity predicted dropouts. CONCLUSIONS: CT retained the patients in therapy longer, showed earlier positive effects on hopelessness and impulsivity, and demonstrated better long-term outcomes on global measures of improvement.

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References

1998The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10 1993Cognitive-Behavioral Treatment of Borderline Personality Disorder 1951Client-Centered Therapy 1995Cognitive Therapy: Basics and Beyond 1991Cognitive-Behavioral Treatment of Chronically Parasuicidal Borderline Patients 2006Two-Year Randomized Controlled Trial and Follow-up of Dialectical Behavior Therapy vs Therapy by Experts for Suicidal Behaviors and Borderline Personality Disorder 2006Outpatient Psychotherapy for Borderline Personality Disorder 1990Relationship between hopelessness and ultimate suicide: a replication with psychiatric outpatients

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2013Borderline Personality Disorder Recent research findings have contributed to an improved understanding and treatment of borderline personality 2018Cognition and self-injurious thoughts and behaviors: A systematic review of longitudinal studies 2017The relationship between therapeutic alliance and patient's suicidal thoughts, self-harming behaviours and suicide attempts: A systematic review 2020Measuring the shadows: A systematic review of chronic emptiness in borderline personality disorder

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