Providing a cost-effective treatment model that is respectful of patients' needs, their strengths, and their limitations, this book presents the first dynamic and coherent approach to group treatment for the chronically mentally ill. By structuring members' variable attendance, the flexibly bound model, which utilizes group dynamic principles to maximize therapeutic opportunities, respects the actual behavior of many chronically ill persons, making this treatment format available to a broad portion of this population. Illustrated with numerous case vignettes, the book outlines the elements of supportive treatment and therapeutic goals and then describes in detail specific strategies and interventions.

This volume focuses on treatment issues pertaining to patients with borderline psychopathology. A section on psychoanalysis and psychoanalytic psychotherapy (with contributors by V. Volkan, H. Searles, O. Kernberg, L. B. Boyer, and J. Oremland, among others) is followed by a section exploring a variety of alternative approaches. The latter include psychopharmacology, family therapy, milieu treatment, and hospitalization. The editors' concluding essay discusses the controversies and convergences among the different treatment approaches.

First published in 1990. Routledge is an imprint of Taylor & Francis, an informa company.

This volume offers guidelines for managing the therapist-patient relationship during crisis intervention and longer-term therapy with patients who exhibit borderline symptoms. Since to do no harm is the primary goal of any therapist who encounters such a patient, an appropriate therapist-patient relationship is crucial; moreover, skillful management of this relationship can, in itself, be the most effective and safe treatment. The authors present a conceptual model, based on self psychology and interpersonal theory, for reframing the borderline symptoms and the therapist's reactions. Case examples demonstrate effective relationship management and therapeutic interventions.

Treating borderline patients is one of the most challenging areas in psychotherapy because of the patient's extreme emotional expressions, the strain it places on the therapist, and the danger of the patient acting out and harming himself or the therapeutic relationship. Many clinicians consider this patient population difficult, if not impossible, to treat. However, in recent years dedicated experts have focused their clinical and research efforts on the borderline patient and have produced treatments that increase our success in working with borderline patients. Transference-Focused Therapy (TFP) is psychodynamic treatment designed especially for borderline patients. This book provides a concise and comprehensive introduction to TFP that will be useful both to experienced clinicians and also to students of psychotherapy. TFP has its roots in object relations and it emphasizes that the transference is the key to understanding and producing change. The patient's internal world of object representations unfolds and is lived in the transference with the therapist. The therapist listens for and makes use of the relationship that is revealed through words, silence, or, as often occurs in the case of individuals with some borderline personality disorder, acting out in subtle or not-so-subtle ways. This primer offers clinicians a way to understand and then use the transference and countertransference for change in the patient.

Borderline Personality Disorder: Tailoring the Psychotherapy to the Patient explores the challenge of treating patients with borderline personality disorder. These patients make up a large segment of the difficult-to-treat population. The instability of their relationships, the intensity of their affective responses, and their proneness to paranoid reactions all contribute to their difficulty in working consistently and constructively in the psychotherapeutic situation. When one adds these difficult patient problems to the therapist's quandary about how expressive or supportive to be, therapists are indeed often confronted with a challenging therapeutic task. The book begins with a review of the clinical and research literature pertaining to the treatment of borderline patients. It presents a unique, empirically based intensive study of three borderline patients, based on transcripts of audiotaped therapy sessions. The research methodology is reviewed, and clinically oriented descriptions of the three patients, their psychotherapy processes, and their outcomes are included. Following an overall summary of results, conclusions regarding the differential indications for supportive versus expressive emphasis in psychotherapy are discussed. In their research, the authors recorded every psychotherapy session and studied a randomly selected group of sessions. Therefore, the reader is provided with increased insight into what is most effective with what kind of patient at a given point in the therapy process.

The as-if patient very often comes to treatment at the behest of someone else, or comes with only the vaguest sense that something is wrong, hence, the patient does not usually notice that nothing is happening in therapy.

This text contains descriptions of how to work with borderline patients.

This book differs from other books on borderline personality disorder in its commitment to empirical data as the basis for progress and understanding when treating the borderline patient. Written by experts in this ever-changing field, it includes research and clinical findings on the etiology and treatment of borderline personality disorder.