 interventions for treating certain criteria of the disorder including depression and traditionally psychotherapeutic interventions. Psychotherapy while perhaps beneficial is often not backed by empirical data supporting this treatment approach. This is because traditional psychotherapy often fails and patients often drop out of treatment. Psychotherapists have even expressed some resistance toward treating BPD patients.
Cognitive Behavioral Perspective
There are other ways to view borderline personality disorder including from a cognitive behavioral perspective. Beck & Freeman (1990) suggest that borderline personality disorder may be addressed via cognitive behavioral techniques that address the expressions "of early maladaptive schemas" (p. 185). They suggest that the cognitive effects of the disorder cause a patient to believe that other people are responsible for satisfying their needs, and represent themselves as helpless in "a hostile world without security" (Beck & Freeman, 1990).
Cognitive behavioral therapy may be useful in treating and preparing patients for transference focused psychotherapy (Appelibaum, et. al, 2000). The CBT treatment approach aims to reduce behaviors that are harmful and life threatening first and foremost and those that interfere with the quality of life (Beck & Freeman, 2000). A cognitive behavioral approach requires that patients are taught to be aware of how their thinking is fundamentally instable, as well as recognize their emotional responses and interpersonal behavior. The goal of therapy is to help the patient develop coping mechanisms that will assist them in dealing with thoughts and feelings (Appelibaum, et. al, 2000).
A critical component of cognitive therapy involves individualized case conceptualization, which may help therapists organize information about a patient (Stenhouse & Van Kessel, 2002). The components of a cognitive treatment model will include analysis of core beliefs, intermediate beliefs and automatic beliefs (cognitive content) with information processing structures that are responsible for psychological responses (Stenhouse & Van Kessel, 2002). The therapist works to mobilize the patient toward achieving a particular goal or aim (Stenhouse & Van Kessel, 2002).
Social workers and psychologists are increasingly seeking out new methods for treating BPD. The latest approach is termed dialectical behavior therapy which is a form of cognitive behavior therapy (Linehan, 1993). This form of therapy combines cognitive and behavioral techniques in a highly structured treatment protocol that has been shown as an effective form of intervention (Osada, 2003).
The treatment described by Linehan defines the pathology of BPD according to the criteria established by the DSM-IV, thus generally patients are considered as having emotional dys-regulation and instability characterized with episodic depression, irritability and anger (Osada, 2003). Impulsive behavior is another characteristic trait with frequent attempts at suicide or self-injury (Linehan, 1993).
Traditionally treating borderline personality disorder has proven difficult in a clinical setting because patients don't often respond to therapeutic efforts and generally drop out of treatment frequently (Osada, 2003). Therapists sometimes avoid treating patients because they are typically resistant and may demonstrate angry characteristics (Osada, 2003). DBT however is an effective treatment tool that combines individual psychotherapy, the traditional approach to BPD with DSM-IV criteria with psychosocial skills training (Osada, 2003).
Few psychosocial treatments for BPD have been shown to be effective when utilized alone as a treatment method for BPD (Osada, 2003; Linehan et. al, 1999). Pharmacotherapy is often commonly utilized as a secondary treatment method to address depressive symptoms however the effects of medication are also somewhat limited in patients with BPD (Osada, 2003). DBT however has shown to effectively treat BPD particularly in patients who demonstrate self-injurious behavior (Osada, 2003; Linehan, 19