Psychotherapeutic interventions for people with complex difficulties and personality disorder

Personality disorders are complex mental health difficulties that were previously considered untreatable. However there is now increasing evidence that psychological therapy can be useful, with Borderline Personality Disorder (BPD) in particular attracting considerable research attention. The first paper systematically reviews 22 studies on psychotherapeutic interventions for BPD. Focusing on the last seven years six distinct therapies, as well as one approach that could not be further classified, were included. The methodological strengths and limitations of each study are discussed. No particular treatment emerged as superior, although it appears that different treatments may target different aspects of BPD and may therefore be more suitable for different BPD subtypes. However, further research is required to establish this clearly. The empirical paper investigated how change occurs in one particular treatment for personality disorder, the therapeutic community (TC). Fifteen former members were interviewed and transcripts were analysed using a modified version of grounded theory. Participants followed two broad trajectories depending on whether or not they overcame initial resistance towards treatment. Those who accepted responsibility for change and were open to TC principles could use relationships and boundaries within the TC to effect wide- ranging change, although the process of change was rarely straightforward. Those who remained resistant and hostile towards the TC experienced a repetition of previous dysfunctional interpersonal patterns, which frequently led to participants leaving the TC with little change having occurred. The results are discussed in the context of wider theories, such as attachment theory. Clinical implications and ideas for future research are highlighted.EThOS - Electronic Theses Online ServiceGBUnited Kingdo