Cognitive-Behavioral Treatment of Borderline Personality Disorder

The two volumes in Dr. Linehan''s program cover the full range of borderline conditions. In her far-reaching new text, COGNITIVE-BEHAVIORAL TREATMENT OF BORDERLINE PERSONALITY DISORDER, Linehan describes in persuasive clinical detail the development and implementation of DBT. Because the behavioral skills training element of her program is so critical for working with borderline individuals, the companion SKILLS TRAINING MANUAL presents session-by-session guidelines for imparting and integrating into the patient''s repertoire four key psychosocial skills notably absent in borderlines. A previous version of this manual has been successfully used in psychiatric hospitals, community health centers, and other settings. Together, the two pieces add up to new promise for respectful, sustained, effective work with this growing patient group. COGNITIVE-BEHAVIORAL TREATMENT OF BORDERLINE PERSONALITY DISORDER Marsha M. Linehan For the average clinician, clinic, or inpatient facility, individuals with borderline personality disorder often represent the most difficult and insoluble cases. Now, set against the backdrop of intense patient pain, and intense frustration (and often anger) on the part of therapists enlisted to help, comes unexpected new hope in the form of Marsha Linehan''s integrative, biosocial approach to borderlines, which she calls Dialectical Behavior Therapy. At once firmly rooted in cognitive-behavioral strategies for change and specifically targeted at the cluster of behavioral problems of most immediate concern (the suicidal and other therapy-interfering behaviors), this is the only approach to date which has been empirically verified in controlled clinical studies. And it is the only approach which simultaneously addresses the BPD''s profound skills deficits, characteristic dichotomous thought and behavior patterns, and extreme relationship needs. A clinical innovator, Linehan begins by positing a biosocial framework which brilliantly links what is well known about the borderline''s difficulties regulating emotions to the environmental milieu in which such emotional sensitivity and inability to modulate emotional responses would be both a likely outcome and, unfortunately, a "poor fit." What she arrives at is the construct of "invalidating environments" (the limiting case of which is the home in which sexual abuse is normalized and the child learns to not feel what she feels). "An invalidating environment," Linehan writes, "is one in which communication of private experiences is met by erratic, inappropriate, and extreme responses....The experience of painful emotions, as well as the factors that to the emotional person seem causally related to the emotional distress, are disregarded." Building on her cogent analysis, Linehan has fashioned a flexible, compassionate, and comprehensive approach to treatment of BPDs rooted in nonjudgmental acceptance of where patients are at the moment, within a context of trying to teach them to change. Touching on everything from how to decrease post-traumatic stress-related behaviors to how to handle the between-session phone call, from how to begin and end sessions to how to avert a suicide, Linehan''s outstanding new text provides genuine hope for a population that has until now challenged clinicians of every orientation. A Companion Manual Includes Client Handouts That May Be Readily Photocopied! SKILLS TRAINING MANUAL FOR TREATING BORDERLINE PERSONALITY DISORDER Marsha M. Linehan This hands-on companion presents in session-by-session replicable detail the clinical strategies designed to remediate four specific skills areas arrested in the BPD patient: "mindfulnesss" (balancing emotion and rationality to achieve wisdom), interpersonal effectiveness, emotion, regulation, and distress tolerance. A vital component in Dr. Linehan''s comprehensive treatment program, the manual also features practical pointers on when to use the other treatment strategies described in COGNITIVE-BEHAVIORAL TREATMENT OF BORDERLINE PERSONALITY DISORDER. Currently employed in a variety of inpatient and outpatient settings, this user-friendly manual provides everything a clinician needs. It includes ''lecture notes,'''' discussion questions, exercises, and practical advice on what problems are likely to arise and how best to deal with them. Published in a large 8 1/2" x 11" format, it also features an array of client handouts that may be readily photocopied. Originally written for skills training groups, the manual can also be used with individual patients. Note About Photocopy Rights: The publisher grants book purchasers permission to reproduce handouts and forms in this book for professional use with their clients.