Core components of a dialectic trial#

Twenty-five years ago, Marsha Linehan published the first randomized control trial (RCT) for dialectical behavioral therapy (DBT), which yielded more significant reduction in the disorder’s most challenging features-parasuicidal behavior, inpatient psychiatric stays, and treatment drop out-than treatment as usual (TAU). Once thought to be an untreatable condition, borderline personality disorder (BPD) is now effectively treated by a growing number of evidence based psychotherapeutic treatments. Evidence-based integrations of DBT and exposure therapy for PTSD provide support for changing practices to simultaneously treat PTSD and BPD.

The research on treatment in BPD is leading to a distillation of intensive packages of treatment to be more broadly and practically implemented in most treatment environments through generalist care models and pared down forms of intensive treatments (e.g., informed case management plus DBT skills training groups). Studies on pharmacological interventions remain limited and have not provided evidence that any specific medications can provide stand-alone treatment. Recent FindingsĮvidence-based advances in the treatment of BPD include a delineation of generalist models of care in contrast to specialist treatments, identification of essential effective elements of dialectical behavioral therapy (DBT), and the adaptation of DBT treatment to manage post-traumatic stress disorder (PTSD) and BPD.

This review summarizes advances in treatments for adults with borderline personality disorder (BPD) in the last 5 years.

Core components of a dialectic