Borderline Personality Disorder Cognitive Behavioral Therapy

The Difference In Treatment Methods

CBT Counseling Role-Play – Clients with Symptoms of Borderline Personality Disorder

CBT focuses on how your thoughts, feelings and behavior influence each other. While DBT does work on these things, emphasis is given more towards regulating emotions, being mindful, and learning to accept pain. CBT seeks to give patients the ability to recognize when their thoughts might become troublesome, and gives them techniques to redirect those thoughts. DBT helps patients find ways to accept themselves, feel safe, and manage their emotions to help regulate potentially destructive or harmful behaviors.

Clients who engage in DBT therapy participate in DBT skills training sessions that are typically taught in a group setting in four modules. Most patients also meet weekly with a DBT therapist or DBT coach and receive DBT phone coaching as needed when they need help the most. Sometimes, once patients are able to use DBT skills to regulate their emotions, practice mindfulness, and improve relationships with others, they are able to transition to more standard CBT groups to address specific negative thought patterns or recurring harmful behaviors.

Philosophical Concerns With Cbt Methods

The methods employed in CBT research have not been the only criticisms some individuals have called its theory and therapy into question.

Slife and Williams write that one of the hidden assumptions in CBT is that of determinism, or the absence of free will. They argue that CBT holds that external stimuli from the environment enter the mind, causing different thoughts that cause emotional states: nowhere in CBT theory is agency, or free will, accounted for.

Another criticism of CBT theory, especially as applied to major depressive disorder , is that it confounds the symptoms of the disorder with its causes.

Goals Of Cognitive Behavioral Therapy

Cognitive Behavioral Therapy is also popular among Borderline Personality Disorder treatments for its quickness and its focus. CBT has clear and concise goals for both the patient and the therapist, and the patient is actually given homework so they may continue their work while not with the therapist.

With its somewhat short time frame , its focus on new skills, and adaptability with other treatment methods, its no wonder why more and more Borderline Personality Disorder treatment centers are adapting Cognitive Behavioral Therapy for BPD treatment.

If you or someone you love has been diagnosed with Borderline Personality Disorder and would like to learn new skills to adapt to a happier life, find a BPD treatment center that offers Cognitive Behavioral Therapy for a more comprehensive and long-term recovery.

  • There is a space on the table for all modalities. However, not all shoe size fits all

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    Differences Between Cbt And Dbt

    CBT and DBT share some common characteristics. Both acknowledge that thoughts influence feelings, which in turn affect behavior. Both require a good relationship between patient and therapist for it to be effective.

    DBT recognizes that those with BPD sometimes dont feel validated or that their emotions seem to be minimized. If this happens, patients end up quitting therapy. DBT adds acceptance and validation to help you accept your feelings as real and valid. When your therapist also accepts your feelings as valid, it helps to build trust in the relationship, so you can work toward a balance between acceptance and change. DBT has been found to be very effective for people who are suicidal or self-harm, because it offers coping skills that work in many different situations.

    We Offer Borderline Personality Disorder Counseling In Cranberry Twp Monroeville And Mt Lebanon

    Cognitive Behavioral Therapy Worksheets for Borderline Personality ...

    Personality disorders are patterns of thinking and behaving that are deeply ingrained in an individuals daily functioning. These patterns are often inflexible and heavily impact a persons relationships. One such pattern of behavior is known as Borderline Personality Disorder . BPD often co-occurs with certain mood disorders, like depression or general anxiety disorder, but is different because it impairs relationships and the ability to control and manage emotions and other feelings. Some symptoms include an irrational fear of abandonment in intimate relationships, increased risk of suicidal behaviors or self-harm, hypersensitivity, hostility, and impulsivity. People with BPD tend to view relationships with a skewed lens of mistrust, which leads to unstable friendships and relationships and can include either over-involvement or withdrawal from the friend or partner. Approximately 18 million Americans are diagnosed with BPD. Borderline personality disorder has a lifetime prevalence of approximately 6%. Women are more likely to have BPD, and it is highly heritable.

    Originally posted on papsychotherapy.org January 2018

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    How To Decide Which Bpd Treatment Is Right For You

    If you have borderline personality disorder, there are treatments that can help you manage your condition. Please speak with your doctor about finding the right therapist and treatment model for you so you can feel better and improve your quality of life.

    Borderline Personality Disorder Discussion Guide

    Get our printable guide to help you ask the right questions at your next doctor’s appointment.

    • A type of cognitive-behavioral therapy

    • Incorporates other skills

    • Specifically treats borderline personality disorder

    The good news is that DBT has been found to be considerably more effective in treating people with borderline personality disorder.

    Dialectical behavioral therapy is recommended as a first-line treatment for borderline personality disorder and has been shown to reduce the need for medical care and medications by as much as 90%.

    It’s interesting to note that some cognitive-behavioral therapists incorporate certain elements of the DBT model into their treatment sessions. Also, other forms of CBT have developed that use the elements of DBT. For instance, mindfulness-based cognitive therapy utilizes traditional cognitive-behavioral techniques with mindfulness to treat depression.

  • Psychotherapy. National Alliance on Mental Health.

  • Cbt Is Based On The Idea That Our Thoughts And Behaviors Influence Our Feelings So Changing The Way We Think About And React To Situations Will Help Us Feel Better

    However, standard CBT isnt effective in treating all mental illnesses. Another common type of therapy is called Dialectical Behavior Therapy . DBT is a more specific form of CBT that focuses on helping people who tend to have extreme emotional reactions interact with the environment around them in a less emotional, healthier wayWith such similar names, are CBT and DBT that different from each other, and can using one have benefits over using the other? Read on to learn about the differences between CBT vs DBT and how to figure out which one will best help you.

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    Is Cbt Effective In Treating Borderline Personality Disorder

    CBT has been shown to be extremely effective at treating BPD. It manages symptoms and is also helpful for children, parents, and relationship partners impacted by an individuals BPD diagnosis.

    CBT is very effective in treating BPD by:8,9,10,11,12

    • Helping couples with a partner who has BPD work through relationship issues by reducing hopelessness and impulse behaviors.
    • Helping individuals reduce suicidal thoughts and behaviors by working to unlearn negative thought processes and relearn positive ways of managing difficult emotions.
    • Helping children with BPD symptoms by providing psychoeducation about how thoughts become actions, and helping parents by integrating their support in sessions to improve overall family functioning and cohesion.
    • Helping those with BPD who are severely struggling with overall functioning. CBT for this population of individuals with BPD showed improvement in psychosocial functioning.
    • Helping those dealing with eating disorders with a diagnosis of BPD. Those with an eating disorder and BPD showed lower dysfunctional behavior around emotions, lower feelings of depression and lower dysfunctional eating behaviors.

    Evidence In Other Domains

    Dr. Alec Miller on Dialectical Behavior Therapy (DBT) for Borderline Personality Disorder

    There is a lack of evidence favoring DBT on core personality features such as interpersonal instability, chronic emptiness, and boredom and identity disturbance or associated symptoms such as depression, suicidal ideation, survival and coping beliefs, overall life satisfaction, work performance, and anxious rumination. DBT was no different in reducing depression than any comparator, be it TAU, CTBE, or general psychiatric management . All therapies showed a reduction in depression over time.

    Except for three studies, which are discussed below, all the other studies have weak methodology and small sample sizes. In the majority of studies, DBT was compared to TAU, which has its own problems such as:

  • It is difficult to know what treatment is given in TAU and it may change over a period of the study
  • TAU sessions are not documented or recorded and thereby adherence and competence ratings cannot be done
  • Patients in TAU comparatively get very less hours of treatment than in active structured treatments.
  • We will discuss only three studies which are rigorous and show us the empirical reality of DBT. Strengths of these studies being adequate power, investigators with a balance of theoretical allegiances , and investigated by an independent group .

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    Limitations Of Dialectical Behavioral Therapy Research And Clinical Implications

  • DBT has a demanding model of therapy. A patient has to attend two separate sessions which include 1 h of individual therapy and 2 h of group skills training every week along with regular homework assignments over at least 1 year of treatment. Therapist has to be available 24/7 for providing emergency behavioral coaching, however rules can be laid down in this to protect therapist from burnout. It can be very costly because of multiple sessions and involvement of highly qualified therapists if it is not delivered through the public health-care system
  • All the DBT studies were of 1 year duration, however as pointed out earlier, Stage I itself many a times takes up to 1 year. Hence, we cannot suppose that studies have tested the whole therapy. Instead, they have tested the usefulness of just one, albeit an important stage of therapy. This might be the reason for the lack of evidence in domains of pathology other than parasuicide
  • DBT needs therapists who are highly qualified and who have to be under regular supervision by attending 2-h consultation team meeting every week for learning skills and supervision. This presents problems with dissemination and resource usage, especially in nonacademic centers, community, and resource-poor settings like India
  • DBT when compared to other structured therapies does not fare well with regard to core features of borderline personality disorder except showing equivalence with regard to improvement in suicide attempts
  • Treatment In Antisocial Personality Disorder

    When a therapist works with a client with antisocial personality disorder many challenges would be there from the beginning. First of all, most of the professionals believed that antisocial personality disorder is an untreatable condition. Thats why they are reluctant to treat patients with ASPD. On the other side of the relationship antisocial patients that are coming for therapy are also very reluctant .

    It is not common that an individual with ASPD goes to the therapists office for getting help for the problems that are already considered so by the environment. They usually come to therapy when their conventional strategies have stopped working and have not been able to get what they wanted or the law or unofficial authority has threatened them. In these conditions, subjects of the admission are usually mood problems, behavioral problems, and alcohol and substance use problems. Another issue while working with ASPD is motivation. From the stages of change perspective, individuals with ASPD are usually at precontemplation or contemplation stages. This suggests that these people believe the source of the problem is from the outside they are not the responsible one or there is some kind of problem but they cannot do anything to solve it.

    Cognitive interventions include introduction of conditional and unconditional beliefs first cognitive restructuring of the intermediate beliefs in terms of rationality and functionality positive schema log and behavioral experiments.

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    What Is Borderline Personality Disorder

    Borderline Personality Disorder generally develops in most people by the time they reach early adulthood. Interacting with others becomes difficult.

    People living with loved ones who are diagnosed or suspected to have BPD often describe feeling they must walk on eggshells around this individual as they present outbursts of anger, extreme anxiety disorder, or desperation with no real reason to feel that way.

    BPD affects about two percent of the general population.

    Differences Between Cbt And Dbt And How To Tell Which Is Right For You

    Cognitive

    Psychotherapy is one of the best treatment methods available for a number of mental illnesses. One of the most common types of therapy is called Cognitive Behavioral Therapy . Also called talk therapy, CBT focuses on talking about your problems to help you frame your thoughts differently. If you feel like negative thoughts are always in control I am a failure. I cant do anything right. No one will like me if they see who I really am. CBT can help you use logic and reason to flip the script and be in control of your thoughts instead of allowing your thoughts to control you.

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    Resources For Family Members

    Family members and partners of individuals with BPD often feel like they themselves need support in dealing with the person with BPD. Family members can feel at a loss for how to deal with individuals when they are so emotionally out of control or when they continue to engage in behavior that seems so self-damaging. Recently, a number of organizations have come into being with the explicit purpose of providing education and resources for family members. These organizations often put on meetings that provide psychoeducation about the disorder as well as tips for interacting with the person with BPD. They also often provide referrals for the family members if they choose to seek therapy for themselves. Here are a few resources that may be useful for family members:

    National Alliance on Mental Illness

    NAMI recently added BPD to its list of mental illnesses that is supported by the organization. Family members can find local support groups and educational opportunities through its website.

    National Education Alliance for BPD

    The mission of NEA-BPD is to raise public awareness, provide education, promote research on borderline personality disorder, and enhance the quality of life of those affected by this serious mental illness. NEA-BPD frequently has workshops around the country and family members are encouraged to attend. You can also listen to a number of presentations on the NEABPD website by leading experts in the field.

    TARA Association for Personality Disorders

    The Basic Concepts In Schema Therapy Of Antisocial Personality Disorder

    As mentioned above, because antisocial personality disordered patients generally do not have enough motivation and referred to therapy for legal reasons, it is hard to keep them in therapy. Patients who have ASPD have very little concern about the consequences of their actions and how the others feel. They see themselves as lonely and victimized, so one of the most important things to move forward in therapy is to build a therapeutic rapport. Therapist uses two important strategieslimited reparenting and empathic confrontationto build a relationship. ASPD patients have strong schemas due to their early childhood memories of unmet basic needs. Limited reparenting provides corrective emotional experience that feeds these unmet needs . The responses, empathic attitude, and behaviors of the therapist construct the limited parenting in therapy sessions.

    Cognitive strategies help the patient build a healthy adult mode, but before that the patient first has to realize his/her mode and then challenge it. It is very obvious that the patient will have difficulty in realizing his/her schema from many aspects it is a life-saving strategy for him/her. So cognitive strategies help the patient to step back and look at the picture from a distance. Cognitive strategies include :

    Reframing the evidence supporting the schema: The therapist and the patient make a list of evidences supporting the schema, and then together generate alternative explanations to provide better understanding.

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    Cbt Vs Dbt For Treating Certain Illnesses

    Not all mental illnesses respond to treatment in the same way. A therapy technique that works well for depression and anxiety can exacerbate eating disorders or personality disorders.CBT has been shown to be incredibly effective when treating depression, and is more likely to make depression go into remission than other types of therapy. This method of therapy has also been proven beneficial in treating anxiety, as it gives patients control over their recovery. CBT has also been shown to help with obsessive compulsive disorder , phobias, panic disorder, post-traumatic stress disorder, and sleeping issues.DBT was created to help those diagnosed with borderline personality disorder. DBT focuses on helping people change their behavior patterns, as opposed to trying to think or talk through the issues they are struggling with. This type of CBT helps those who have developed patterns of intense emotional reactions and impulsive behaviors in response to what patients describe as overwhelming feelings of pain and rejection the feeling of walking through a world filled with knives. DBT often is the most effective therapy for those who struggle with self-harm behaviors like cutting and chronic suicidal ideation. Sexual trauma survivors also respond well to DBT techniques.

    Dementia And Mild Cognitive Impairment

    Validation for Patients with Borderline Personality Disorder

    A Cochrane review in 2022 found that adults with dementia and mild cognitive impairment who experience symptoms of depression may benefit from CBT, whereas other counselling or supportive interventions might not improve symptoms significantly. Across 5 different psychometric scales, where higher scores indicate severity of depression, adults receiving CBT reported somewhat lower mood scores than those receiving usual care for dementia and MCI overall. In this review, a sub-group analysis found clinically significant benefits only among those diagnosed with dementia, rather than MCI.

    The likelihood of remission from depression also appeared to be 84% higher following CBT, though the evidence for this was less certain. Anxiety, cognition and other neuropsychiatric symptoms were not significantly improved following CBT, however this review did find moderate evidence of improved quality of life and daily living activity scores in those with dementia and MCI.

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