Cognitive-Behavioral Treatment of Borderline Personality Disorder
For the average clinician, clinic, or inpatient facility, individuals with borderline personality disorder often represent the most difficult and insoluble cases. The first volume to provide strategies proven effective in controlled clinical trials, this book is a comprehensive, integrated approach to therapy with this population. Marsha Linehan presents specific guidelines that creatively combine the best elements of behavioral, psychoanalytic, strategic, and other commonly employed...
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This volume is the authoritative presentation of Dialectical Behavior Therapy (DBT), Linehan's comprehensive, integrated approach to treating individuals with borderline personality disorder. DBT--which has since been adapted for other difficult-to-treat disorders involving emotion dysregulation--combines cognitive and behavioral strategies with elements of psychodynamic, strategic, and other modalities. Delineated are specific strategies for contingency management, exposure, cognitive modification, and skills training. In-depth descriptions of skills training procedures are provided in the companion manual. Core emotion regulation skills are also taught directly to clients in Linehan's skills training videos.
I. THEORY AND CONCEPTS. \ 1. Borderline Personality Disorder: Concepts, Controversies, and Definitions. \ 2. Dialectical and Biosocial Underpinnings of Treatment. \ 3. Behavioral Patterns: Dialectical Dilemmas in the Treatment of Borderline Patients. \ II. TREATMENT OVERVIEW AND GOALS. \ 4. Overview of Treatment: Targets, Strategies, and Assumptions in a Nutshell. \ 5. Behavioral Targets in Treatment: Behaviors to Increase and Decrease. \ 6. Structuring Treatment Around Target Behaviors: Who Treats What and When. \ III. BASIC TREATMENT STRATEGIES. \ 7. Dialectical Treatment Strategies. \ 8. Core Strategies: Part I. Validation. \ 9. Core Strategies: Part II. Problem Solving. \ 10. Change Procedures: Part I. Contingency Procedures (Managing Contingencies and Observing Limits. \ 11. Change Procedures: Part II. Skill Training, Exposure, Cognitive Modification. \ 12. Stylistic Strategies: Balancing Communication. \ 13. Case Management Strategies: Interacting with the Community. \ IV. STRATEGIES FOR SPECIFIC TASKS. \ 14. Structural Strategies. \ 15. Special Treatment Strategies.
Pt. ITheory and Concepts1Borderline Personality Disorder: Concepts, Controversies, and Definitions32Dialectical and Biosocial Underpinnings of Treatment283Behavioral Patterns: Dialectical Dilemmas in the Treatment of Borderline Patients66Pt. IITreatment Overview and Goals4Overview of Treatment: Targets, Strategies, and Assumptions in a Nutshell975Behavioral Targets in Treatment: Behaviors to Increase and Decrease1206Structuring Treatment Around Target Behaviors: Who Treats What and When165Pt. IIIBasic Treatment Strategies7Dialectical Treatment Strategies1998Core Strategies: Part I. Validation2219Core Strategies: Part II. Problem Solving25010Change Procedures: Part I. Contingency Procedures (Managing Contingencies and Observing Limits)29211Change Procedures: Part II. Skills Training, Exposure, Cognitive Modification32912Stylistic Strategies: Balancing Communication37113Case Management Strategies: Interacting with the Community399Pt. IVStrategies for Specific Tasks14Structural Strategies43715Special Treatment Strategies462Appendix: Suggested Reading524References527Index547
\ From the Publisher\ "Every once in a very long while in our field, a clinical innovation is introduced that profoundly improves patient care. Marsha Linehan's development of a cognitive-behavioral approach to borderline personality disorder is such a rare innovation....Her techniques are clear, teachable, and learnable, and make good common sense to the therapist and the patient. Dr. Linehan's methods have greatly improved my treatment of borderline individuals and my teaching of others in how best to understand and treat these patients.'--Allen Frances, MD\ "Marsha Linehan's tremendously in-depth and informative book and its companion skills-training manual offer a needed guide to the cognitive-behavioral treatment of borderline personality disorder....Her method has become so widely used by clinicians that the experts in psychosocial treatments consider it one of the best....Marsha Linehan's methods are highly eclectic because they are empirically based; they have been fashioned to fit what works best for borderline patients."--Lester Luborsky, PhD\ "Linehan is one of our most creative and articulate clinicians....As a true scientist-professional, she has not only been innovating in the treatment of one of the most daunting of disorders--borderline personality--but has successfully subjected her ideas to controlled empirical scrutiny."--Gerald Davison, PhD, University of Southern California\ "Dr. Linehan's approach is sensible, pragmatic, and effective. Most importantly, it offers the therapist a humane and sensitive perspective on persons with Borderline Personality Disorder. In short, it treats both the therapist and the client in a fashion that produces results."--Mark Ciocca, PhD, Central New Hampshire Community Mental Health Center\ "Linehan is a brilliant, compassionate, and rigorous therapist for borderline patients. What's more, and what is most unusual for master therapists, she has proven its efficacy in published randomized, controlled trials. What is fortuitous for borderline patients and their therapists is that she has painstakingly crafted a wise book and user-friendly manual well grounded in principle, detailed in its strategies, and exportable to a wide range of treatment settings. Our hospital has applied Linehan's treatment in several settings over the past five years: acute inpatient, extended inpatient, day treatment, and outpatient. We have primarily worked with borderline clients, but have also had success with some schizophrenics. Patients, families, and staff have received this new approach with enthusiasm; it makes common sense to them and feels very practical. It's a treatment that integrates well with biological, rehabilitative, most psychodynamic, and family treatment modes, and parallels treatments for eating disorders, substance abuse, and PTSD from childhood abuse....Linehan has set a high standard of treatment for borderlines in the 1990s; the patients will be the ultimate beneficiaries."--Charles R. Swenson, MD, New York Hospital, Westchester Division\ \ \ \ \ \ Bulletin of the Menninger Clinic\ "We highly recommend this text and its companion training manual...."--Bulletin of the Menninger Clinic\ \ \ Behaviour Research and Therapy\ "...represents a gold standard" for treatment of this diagnostic category."--Behaviour Research and Therapy\ \ \ \ \ Journal of Family Violence\ "It is the most exacting and well thought out treatment plan I have ever seen written for any disorder....I have tried to find shortcomings with this book. I can find none. It is one of the best pieces of clinical work ever written. No matter what your clinical or research focus of interest, you will gain immensely from reading Cognitive-Behavioral Treatment of Borderline Personality Disorder."--Journal of Family Violence\ \
