DIAGNOSIS: Borderline Personality Disorder
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Transference-Focused Therapy for Borderline Personality Disorder
Status: Strong/Controversial Research Support
Transference-Focused Therapy (TFP) focuses on revealing the underlying causes of a patient's borderline condition and working to build new, healthier ways for the patient to think and behave. From the perspective of TFP, the borderline patient's perceptions of self and of others are split into unrealistic extremes of bad and good. These conflicting dyads are thought to be expressed through the specific self-destructive symptoms of BPD. The term “transference” refers to the patent’s experience of his or her moment-to-moment relationship with the therapist. The treatment focuses on transference, because it is believed that patients will display their unhealthy dyadic perceptions not only in day-to-day life, but also in the interactions they have with their therapist. TFP focuses on using patient-therapist communications to help the patient integrate these different representations of self and, in the process, develop better methods of self-control.
TFP has the unusual designation of strong/controversial research support because of mixed findings. TFP performed favorably in one randomized controlled trial (Doering et al., 2010) and performed similarly to dialectical behavior therapy and supportive therapy in another randomized controlled trial (Clarkin et al., 2007), but performed less well than a comparison treatment in another (Giesen-Bloo et al., 2006). More research is needed to clarify the research status of TFP.
Key References (in reverse chronological order)
Doering, S., Horz, S., Rentrop, M., Fishcer-Kern, M. et al. (2010). Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial. British Journal of Psychiatry, 196, 389-395.
Clarkin, J.F., Levy, K.N., Lenzenweger, M.F., and Kenberg, O.F. (2007). Evaluating Three Treatments for Borderline Personality Disorder: A Multiwave Study. The American Journal of Psychiatry, 164, 922-928.
Giesen-Bloo, J., van Dyck, R., Spinhoven, P., van Tilburg, W., Dirksen, C., van Asselt, T., et al. (2006). Outpatient psychotherapy for borderline personality disorder: Randomized trial of schema-focused therapy vs. transference-focused psychotherapy. Archives of General Psychiatry, 63, 649–658.
- Clarkin, JF, Yeomans, FE, & Kernberg, OF (2006). Psychotherapy for Borderline Personality. Focusing on Object Relations. Washington, DC: American Psychiatric Publishing.
- Clarkin, JF, Yeomans, FE, & Kernberg, OF (1999). Psychotherapy for Borderline Personality. New York: J. Wiley and Sons.
- Yeomans, FE, Clarkin JF, & Kernberg, OF (2002). A Primer of Transference-Focused Psychotherapy for the Borderline Patient. Northvale, NJ: Jason Aronson.
- Training opportunities are available through The Center for Transference-Focused Psychotherapy
- Training opportunities are available through The Personality Disorders Institute
Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice