Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide

by Frank E. Yeomans MD PhD, John F. Clarkin PhD, Otto F. Kernberg MD

Overview

Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide presents a model of borderline personality disorder (BPD) and its treatment that is based on contemporary psychoanalytic object relations theory as developed by the leading thinker in the field, Otto Kernberg, M.D., who is also one of the authors of this insightful manual. The model is supported and enhanced by material on current phenomenological and neurobiological research and is grounded in real-world cases that deftly illustrate principles of intervention in ways that mental health professionals can use with their patients.

The book first provides clinicians with a model of borderline pathology that is essential for expert assessment and treatment planning and then addresses the empirical underpinnings and specific therapeutic strategies of transference-focused psychotherapy (TFP). • From the chapter on clinical assessment, the clinician learns how to select the type of treatment on the basis of the level of personality organization, the symptoms the patient experiences, and the areas of compromised functioning. In order to decide on the type of treatment, the clinician must examine the patient's subjective experience (such as symptoms of anxiety or depression), observable behaviors (such as investments in relationships and deficits in functioning), and psychological structures (such as identity, defenses, and reality testing). • Next, the clinician learns to establish the conditions of treatment through negotiating a verbal treatment contract or understanding with the patient. The contract defines the responsibilities of each of the participants and defines what the reality of the therapeutic relationship is. • Techniques of treatment interventions and tactics to address particularly difficult clinical challenges are addressed next, equipping the therapist to employ the four primary techniques of TFP (interpretation, transference analysis, technical neutrality, and use of countertransference) and setting the stage for and guiding the proper use of those techniques within the individual session.• What to expect in the course of long-term treatment to ameliorate symptoms and to effect personality change is covered, with sections on the early, middle, and late phases of treatment. This material prepares the clinician to deal with predictable phases, such as tests of the frame, impulse containment, movement toward integration, episodes of regression, and termination.• Finally, the text is accompanied by supremely instructive online videos that demonstrate a variety of clinical situations, helping the clinician with assessment and modeling critical therapeutic strategies. The book recognizes that each BPD patient presents a unique treatment challenge. Grounded in the latest research and rich with clinical insight, Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide will prove indispensable to mental health professionals seeking to provide thoughtful, effective care to these patients.

Product Details

ISBN-13:	9781585624379
Publisher:	American Psychiatric Association Publishing
Publication date:	12/30/2014
Pages:	427
Product dimensions:	6.00(w) x 8.90(h) x 1.10(d)
Age Range:	18 Years

About the Author

Frank E. Yeomans, M.D., Ph.D., is Clinical Associate Professor of Psychiatry at Weill Cornell Medical College, Director of Training at the Personality Disorders Institute at Weill Cornell Medical College, and Adjunct Associate Professor of Psychiatry at the Columbia Center for Psychoanalytic Training and Research, New York, New York.

John F. Clarkin, Ph.D., is Codirector of the Personality Disorders Institute at Weill Cornell Medical College and Clinical Professor of Psychology in Psychiatry at Weill Cornell Medical College, New York, New York.

Otto F. Kernberg, M.D., is Director of the Personality Disorders Institute at Weill Cornell Medical College, Professor Emeritus at Weill Cornell Medical College, and Training and Supervising Analyst at Columbia University Center for Psychoanalytic Training and Research, New York, New York.

Table of Contents

ABOUT THE AUTHORSPREFACEVIDEO GUIDE Chapter 1. The Nature Of Normal And Abnormal Personality OrganizationChapter 2. Empirical Development Of Transference-Focused Psychotherapy: A Clinical Research ProcessChapter 3. Strategies Of Transference-Focused PsychotherapyChapter 4. Assessment Phase: Clinical Evaluation And Treatment Selection Chapter 5. Establishing The Treatment Frame: Contracting, Medication, And Adjunctive Treatments Chapter 6. Techniques Of Treatment: Moment-To-Moment Interventions And Mechanisms Of Change Chapter 7. Tactics Of Treatment And Clinical ChallengesChapter 8. Early Treatment Phase: Test Of The Frame, Impulse Containment, And Identifying DYADS Chapter 9. Midphase Of Treatment: Movement Toward Integration With Episodes of Regression Chapter 10. Advance Phase Of Treatment and TerminationChapter 11. Trajectories Of Change In Transference-Focused PsychotherapyREFERENCESINDEX

What People are Saying About This

Elizabeth L. Auchincloss

In Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide, Yeomans, Clarkin, and Kernberg have given us a remarkable book that is both sophisticated and user-friendly. They explain theories of character, psychopathology, and treatment in simple terms, giving clinical examples that illustrate complex ideas. This book will be useful to those interested in the treatment of borderline personality disorder, and in the application of psychodynamic psychotherapy to the treatment of all patients. It will also be useful to both students, and experienced clinicians alike.

Robert Michels

Transference-focused psychotherapy (TFP) is based on one of the foundations of psychoanalytic thinking, object relations theory, and has been developed with rigorous research methodology and empirical evaluation. Designed for the most difficult patients in the dynamic therapist's caseload, those with borderline personality, this treatment offers not only relief of symptoms but also an approach to their underlying personality disorder. It promises to enhance their social and vocational functioning, their love lives, and their creativity.

In this guide for clinicians, Yeomans, Clarkin, and Kernberg, who developed the treatment, describe the origins of TFP and walk the clinician through its stages. They discuss case selection, establishing and maintaining the frame, and development and analysis of the transference. They provide guidance in managing crises, suicidality, sexual enactments, and more, all richly illustrated with clinical examples. This book is a must for anyone who wants to understand or employ TFP or for anyone who works with borderline patients.

John M. Oldham

Transference-Focused Psychotherapy (TFP) is well established as an evidence-based, effective treatment for borderline personality disorder, but the work is anything but easy! This volume by Yeomans, Clarkin, and Kernberg is a remarkable roadmap for clinicians—truly a GPS for TFP that maps the treatment terrain with authenticity and expertise. Highly recommended for all therapists working with borderline patients.

Editorial Reviews

This book is well worth the time and attention of residents, practicing psychiatrists, and other mental health clinicians whether they are new to therapy, new to psychodynamic therapy, or experienced therapists. Although I have been practicing for close to 40 years, I learned new things from it, and I have already recommended the volume to colleagues who are eager to begin learning in greater depth about psychodynamic theory and the technique of therapy. My advice was to get into the book, take it seriously, and work away at it. For those with the ability to do so, making it the work of a reading group to support each other's learning, or with a supervisor, or both, may make sense. And the authors also offer TFP courses online and at various sites around the country.

Journal of Psychiatric Practice Vol. 23, No. 4 - Eric M. Plakun

Reviewer: Jeremy Petrous, D.O.(Pine Rest Christian Mental Health Services)
Description: This book first provides a model of borderline personality disorder pathology that is essential for expert assessment and treatment planning and then addresses the empirical underpinnings and specific therapeutic strategies of transference-focused psychotherapy (TFP).
Purpose: The purpose is to provide a detailed clinical guide to understanding and treating patients with borderline personality disorder from a psychoanalytic, transference-focused approach.
Audience: The audience is mental health professionals seeking to provide thoughtful, effective care to patients with borderline personality disorder.
Features: The book begins broadly by explaining normal and abnormal personality organization and the development of transference-focused psychotherapy. It then describes the different phases of treatment including assessment, establishing the treatment frame, techniques of treatment, and the early, mid, and advanced phases of treatment. The book is filled with helpful tables. A major change to this edition is the inclusion of video demonstrations of treatment available online. Each chapter concludes with bulleted key clinical concepts and a section on selected readings for further study.
Assessment: This book walks readers through an explanation of borderline personality disorder and the use of transference-focused therapy, which satisfies its goal as a clinical guide. Its strengths include its practicality and vast number of case examples in the book and video demonstrations online, which sets it apart from similar books. The tables add value and provide helpful tidbits such as "factors that may contribute to the patient's urge to drop out of treatment" and a sample suicide contract, to name a few. The first few chapters on personality organization and the development of transference-focused therapy are admittedly tedious and less captivating, but they do provide the framework for the rest of the book. The authors do an excellent job of engaging readers in the remainder of the book by combining theory and clinical practicality. Overall, I would highly recommend this to mental health professionals interested in developing their therapy skills for borderline personality disorder patients.

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