Intensive Dialectical Behavior Therapy for Outpatients With BorderlinePersonality Disorder Who Are in Crisis

Annabel McQuillan · Rosetta Nicastro · Florence Guenot · Michèle Girard · Catherine Lissner · François Ferrero

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

Abstract

OBJECTIVE: This study examined the effectiveness of an intensive version of dialectical behavior therapy for patients in an outpatient setting who met criteria for borderline personality disorder and who were in crisis. METHODS: Over the two-year study period, 127 patients (103 women) between the ages of 18 and 52 years were referred to the program; 87 were admitted, and because of a limited number of places, 40 were referred elsewhere. Patients were admitted after recent suicidal or parasuicidal behavior, and the most suicidal patients were given priority. The treatment was a three-week intensive version of dialectical behavior therapy consisting of individual therapy sessions; an emphasis on skills training provided in groups, including mindfulness skills; and team consultation. A diagnostic interview was administered, and patients were screened with the International Personality Disorder Examination Screening Questionnaire, the Beck Depression Inventory (BDI), the Beck Hopelessness Scale (BHS), and the Social Adaptation Self-Evaluation Scale. RESULTS: The only significant difference at intake between patients admitted to the program and those referred elsewhere was a slighter higher incidence of antisocial traits in the latter group. Of the 87 patients admitted, 71 (82 percent) completed the program and 16 (18 percent) dropped out. Pre-post analysis showed significant improvement in scores on the BDI and BHS. CONCLUSIONS: The three-week, intensive version of dialectical behavior therapy was found to be an effective treatment. Treatment completion was high, and patients showed statistically significant improvements in depression and hopelessness measures. This approach allowed therapists to treat a large number of patients in a short time.

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References

1961An Inventory for Measuring Depression 1993Cognitive-Behavioral Treatment of Borderline Personality Disorder 1974The measurement of pessimism: The Hopelessness Scale.2000Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy.1993Skills Training Manual for Treating Borderline Personality Disorder 1991Cognitive-Behavioral Treatment of Chronically Parasuicidal Borderline Patients 1999Effectiveness of Partial Hospitalization in the Treatment of Borderline Personality Disorder: A Randomized Controlled Trial 2000Risk factors for suicide in psychiatric outpatients: A 20-year prospective study.

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2017Patients with Borderline Personality Disorder in Emergency Departments 2020Measuring the shadows: A systematic review of chronic emptiness in borderline personality disorder 2012Mindfulness skills in borderline personality disorder patients during dialectical behavior therapy: Preliminary results 2012Crisis interventions for people with borderline personality disorder 2016Psychometric properties of the French borderline symptom list, short form (BSL-23)

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