Evidence Based Treatment of
Borderline Personality Disorder
Jeff Riggenbach, PhD, LPC
Overview of Seminar
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Introduction
Definitions
Outcome Research
Treatment Model
Case Studies
Personality Disorder Definitions
DSM Definition:
An enduring pattern of inner experience and behavior that
deviates markedly from the individual’s culture, is pervasive and
inflexible, has onset in adolescence or early adulthood, is stable
over time, and leads to distress or impairment.
Personality Disorder Definitions
Shea’s “no nonsense” definition:
An ongoing set of defense mechanisms that
considerable distress for self and
others.
cause
Personality Disorder Definitions
Family Member’s definitions:
- “Manipulative”
- “Mean”
- “Sneaky”
- Hurtful
Personality Disorder Definitions
Clinical Definitions:
Any referral preceded by an apology.
Personality Disorder Definitions
Functional definition:
“People who have unusual ways of asking for help”
Borderline Personality Disorder
Outcome Studies
- Dialectical Behavior Therapy
- Cognitive-Behavioral Therapy
- MBT/TFP
- Schema-Focused Therapy
Borderline Personality Disorder
The Treatment Model
CBT - Tenets
Levels of Cognition
Automatic
Thoughts
Conditional Assumptions
Core Beliefs
Schema Definitions
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Term “Schema” originally coined by Piaget in
1926 – “structures that inte-grate meaning into
events”
Schema Definitions
Beck – “Cognitive structures that organize
experience and behavior”
Landau and Goldfried -- a mental filter that guides
processing of information
Schema Definitions
Core beliefs/Schemas
Beck – “Cognitive structures that organize
experience and behavior”
Landau and Goldfried -- a mental filter that guides
processing of information
Belief Modification Protocol
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Identify the Maladaptive Belief
Identify Alternate Adaptive Belief
Rate Baseline Believability
Interventions
Rate Believability at Regular Intervals
Data Logs
SFT - Tenets
Young – “Early Maladaptive Schema”
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18 Schemas grouped into 5 schema domains
Domain # 1: Disconnection & Rejection
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Abandonment
Mistrust
Defectiveness
Emotional Deprivation
Social Isolation
SFT - Tenets
Young – “Early Maladaptive Schema”
Domain # 2: Impaired autonomy and
Performance
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Dependence
Vulnerability
Enmeshment
Failure
SFT - Tenets
Young – “Early Maladaptive Schema”
Domain # 3: Impaired Limits
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Entitlement/Grandiosity
Insufficient Self-Control
SFT - Tenets
Young – “Early Maladaptive Schema”
Domain # 4: Others Directedness
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Subjugation
Self-Sacrifice
Approval-Seeking
SFT - Tenets
Young – “Early Maladaptive Schema”
Domain # 5: Overvigilance
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Negativity/Pessimism
Emotional Inhibition
Unrelenting standards/hypercriticalism
Punitiveness
Borderline Personality Disorder
Schema Modification Treatment
CASE STUDIES/INTERVENTIONS
Schema Modification Interventions
- Collection of Historical Data
- Behavioral Pattern Breaking
- Data Logs
- Internalization Exercises
- Schema Mode Work
Borderline Personality Disorder
Schema Modification Treatment
Historical Data Logs
Borderline Personality Disorder
Schema Modification Treatment
Behavioral Pattern Breaking
Borderline Personality Disorder
Schema Modification Treatment
Ongoing Data Logs
Borderline Personality Disorder
Schema Modification Treatment
Internalization Exercises
Questions?
Thank You!