Dialectical Behaviour Therapy for People with Borderline Personality Disorder: A Rapid Qualitative Review [Internet]

Excerpt

Borderline personality disorder (BPD) is one of the most common personality disorders. As a condition, it is characterized by people having difficulty regulating or handling their emotions and controlling their impulses. People living with BPD typically struggle with sense of self and self-image and their interpersonal relationships. They are often highly sensitive to what is going around them and react with intense and volatile emotions. People living with BPD often experience feelings of hopeless and emptiness, and engage in self-harm and suicidal behaviours. Comorbidities are very common with BPD. People living with BPD often also have depression, anxiety, post-traumatic stress disorder (PTSD), substance use or other personality disorders.

Psychotherapy is a primary treatment for BPD. Dialectical behaviour therapy (DBT) is an established psychotherapy based on the theory that BPD arises when emotionally vulnerable individuals grow up in an environment that is invalidating or dysfunctional. It is designed to help individuals come to accept themselves and develop skills for change. Typically a 12-month program, it involves five components:

1. Group skills training to introduce effective and practical skills (i.e., mindfulness, distress tolerance, interpersonal effectiveness and emotional regulation) which can replace other negative behaviours used to respond to emotional distress;

2. Individual psychotherapy to help individuals set and meet goals, be motivated, and apply their practical skills;

3. Telephone coaching to provide in-the-moment support for when people with BPD experience distress and help them with applying their DBT skills;

4. Case management strategies that empower individuals to take control of their lives and care;

5. DBT consultation team helps therapists stay motivated and competent to avoid burnout and share knowledge so they can provide the best treatment possible.

DBT is used with people living with BPD as well as people living with PTSD, substance use disorders, suicidal behaviour and self-harm.

When considering expanding access to or implementing DBT, it is important to consider how it is viewed and experienced by those living with BPD. The purpose of this review is to provide information on the experiences and views of people living with BPD and people involved in their lives (e.g., family, friends) on accessing and undergoing therapy for BPD, specifically DBT.