Cognitive-behavioral treatment of borderline personality disorder:
For the average clinician, clinic, or inpatient facility, individuals with borderline personality disorder often represent the most difficult and insoluble cases. The first volume to provide strategies proven effective in controlled clinical trials, this book is a comprehensive, integrated approach...
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
New York [u.a.]
Guilford Press
1993
|
| Schriftenreihe: | Diagnosis and treatment of mental disorders
|
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Zusammenfassung: | For the average clinician, clinic, or inpatient facility, individuals with borderline personality disorder often represent the most difficult and insoluble cases. The first volume to provide strategies proven effective in controlled clinical trials, this book is a comprehensive, integrated approach to therapy with this population. Marsha Linehan presents specific guidelines that creatively combine the best elements of behavioral, psychoanalytic, strategic, and other commonly employed modalities. A clinical innovator, she has analyzed the aspects of borderline into their component parts and developed a systematized approach to each of them. The first section of the book presents an overview of the disorder and lays out a theoretical framework to guide the therapy. The second describes in detail how to assess borderline patients and how to organize and prioritize treatment goals and behavioral targets The core of the treatment is the balance of acceptance and change strategies, both within each therapy interaction and over time. For problem solving with borderline personality disorder, the book provides specific strategies for contingency management, exposure, cognitive modification, and skills training. The last component is further elucidated in the companion Skills Training Manual, which programmatically details procedures and includes client handouts for step-by-step implementation. Finally, to enhance interpersonal communication, Dr. Linehan presents three case management sets: consultation to the patient, environmental intervention, and consultation to the therapist. Addressing the most stressful patient behaviors that clinicians encounter, the book includes a step-by-step outline for assessing suicide risk, managing suicide threats, and working with chronic suicidal behavior Integrative approaches for such specific problems as crises, noncompliance, and breakdowns in the therapeutic relationship are also discussed. Lucidly detailing effective techniques that can be replicated in clinical practice, this volume illuminates the internal experience of borderline individuals and provides clinicians with practical clinical tools for working with them. As such, it is an invaluable resource for all professionals who work with this difficult-to-treat population |
| Beschreibung: | XVII, 558 S. |
| ISBN: | 0898621836 |
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| 520 | 3 | |a For the average clinician, clinic, or inpatient facility, individuals with borderline personality disorder often represent the most difficult and insoluble cases. The first volume to provide strategies proven effective in controlled clinical trials, this book is a comprehensive, integrated approach to therapy with this population. Marsha Linehan presents specific guidelines that creatively combine the best elements of behavioral, psychoanalytic, strategic, and other commonly employed modalities. A clinical innovator, she has analyzed the aspects of borderline into their component parts and developed a systematized approach to each of them. The first section of the book presents an overview of the disorder and lays out a theoretical framework to guide the therapy. The second describes in detail how to assess borderline patients and how to organize and prioritize treatment goals and behavioral targets | |
| 520 | 3 | |a The core of the treatment is the balance of acceptance and change strategies, both within each therapy interaction and over time. For problem solving with borderline personality disorder, the book provides specific strategies for contingency management, exposure, cognitive modification, and skills training. The last component is further elucidated in the companion Skills Training Manual, which programmatically details procedures and includes client handouts for step-by-step implementation. Finally, to enhance interpersonal communication, Dr. Linehan presents three case management sets: consultation to the patient, environmental intervention, and consultation to the therapist. Addressing the most stressful patient behaviors that clinicians encounter, the book includes a step-by-step outline for assessing suicide risk, managing suicide threats, and working with chronic suicidal behavior | |
| 520 | 3 | |a Integrative approaches for such specific problems as crises, noncompliance, and breakdowns in the therapeutic relationship are also discussed. Lucidly detailing effective techniques that can be replicated in clinical practice, this volume illuminates the internal experience of borderline individuals and provides clinicians with practical clinical tools for working with them. As such, it is an invaluable resource for all professionals who work with this difficult-to-treat population | |
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Datensatz im Suchindex
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| adam_text | IMAGE 1
CONTENTS
PART I. THEORY AND CONCEPTS 1. BORDERLINE PERSONALITY DISORDER: 3
CONCEPTS, CONTROVERSIES, AND DEFINITIONS
- THE CONCEPT OF BORDERLINE PERSONALITY DISORDER / 5 THE CONCEPT OF
PARASUICIDAL BEHAVIORS / 13 THE OVERLAP BETWEEN BORDERLINE PERSONALITY
DISORDER AND PARASUICIDAL BEHAVIOR / 15 THERAPY FOR BORDERLINE
PERSONALITY DISORDER: A PREVIEW / 19
CONCLUDING COMMENTS / 25 NOTES / 26
2. DIALECTICAL AND BIOSOCIAL UNDERPINNINGS OF TREATMENT 28 DIALECTICS /
28 BORDERLINE PERSONALITY DISORDER AS DIALECTICAL FAILURE / 35 CASE
CONCEPTUALIZATION: A DIALECTICAL
COGNITIVE-BEHAVIORAL APPROACH /37 BIOSOCIAL THEORY: A DIALECTICAL THEORY
OF BORDERLINE PERSONALITY DISORDER DEVELOPMENT / 42 IMPLICATIONS OF THE
BIOSOCIAL THEORY FOR THERAPY
WITH BORDERLINE PATIENTS / 62 CONCLUDING COMMENTS / 64 NOTES / 65
3. BEHAVIORAL PATTERNS: DIALECTICAL DILEMMAS 66
IN THE TREATMENT OF BORDERLINE PATIENTS
EMOTIONAL VULNERABILITY VERSUS SELF-INVALIDATION / 67 ACTIVE PASSIVITY
VERSUS APPARENT COMPETENCE / 78 UNRELENTING CRISES VERSUS INHIBITED
GRIEVING / 85 CONCLUDING COMMENTS / 93 NOTES / 94
IMAGE 2
XII CONTENTS
PART II. TREATMENT OVERVIEW AND GOALS
4. OVERVIEW OF TREATMENT: TARGETS, STRATEGIES, 97
AND ASSUMPTIONS IN A NUTSHELL CRUCIAL STEPS IN TREATMENT / 97 SETTING
THE STAGE: GETTING THE PATIENT S ATTENTION 97 / STAYING DIALECTICAL 98 /
AP- PLYING CORE STRATEGIES: VALIDATION AND PROBLEM SOLVING 99 /
BALANCING INTERPER-
SONAL COMMUNICATION STYLES 100 / COMBINING CONSULTATION-TO-THE-PATIENT
STRATEGIES WITH INTERVENTIONS IN THE ENVIRONMENT 101 / TREATING THE
THERAPIST 101 MODES OF TREATMENT / 101 INDIVIDUAL OUTPATIENT
PSYCHOTHERAPY 102 / SKILLS TRAINING 103 / SUPPORTIVE PROCESS
GROUP THERAPY 103 / TELEPHONE CONSULTATION 104 / CASE CONSULTATION
MEETINGS FOR THERAPISTS 104 / ANCILLARY TREATMENTS 105 ASSUMPTIONS ABOUT
BORDERLINE PATIENTS AND THERAPY / 106 1. PATIENTS ARE DOING THE BEST
THEY CAN 106 / 2. PATIENTS WANT TO IMPROVE 106
/ 3. PATIENTS NEED TO DO BETTER, TRY HARDER, AND BE MORE MOTIVATED TO
CHANGE 106 / 4. PATIENTS MAY NOT HAVE CAUSED ALL OF THEIR OWN PROBLEMS,
BUT THEY HAVE TO SOLVE THEM ANYWAY 107 / 5. THE LIVES OF SUICIDAL,
BORDERLINE INDIVIDU- ALS ARE UNBEARABLE AS THEY ARE CURRENTLY BEING
LIVED 107 / 6. PATIENTS MUST LEARN NEW BEHAVIORS IN ALL RELEVANT
CONTEXTS 107 / 7. PATIENTS CANNOT FAIL IN THERAPY
108 / 8. THERAPISTS TREATING BORDERLINE PATIENTS NEED SUPPORT 108
THERAPIST CHARACTERISTICS AND SKILLS / 108 STANCE OF ACCEPTANCE VERSUS
CHANGE 109 / STANCE OF UNWAVERING CENTEREDNESS VERSUS COMPASSIONATE
FLEXIBILITY 110 / STANCE OF NURTURING VERSUS BENEVOLENT DEMAND-
ING 111 AGREEMENTS OF PATIENTS AND THERAPISTS / 112 PATIENT AGREEMENTS
112 / THERAPIST AGREEMENTS 115 THERAPIST CONSULTATION AGREEMENTS / 117
DIALECTICAL AGREEMENT 117 / CONSULTATION-TO-THE-PATIENT AGREEMENT 117 /
CON- SISTENCY AGREEMENT 117 / OBSERVING-LIMITS AGREEMENT 118 /
PHENOMENOLOGICAL EMPATHY AGREEMENT 118 / FALLIBILITY AGREEMENT 118
CONCLUDING COMMENTS / 119 NOTE / 119
5. BEHAVIORAL TARGETS IN TREATMENT: 120
BEHAVIORS TO INCREASE AND DECREASE T HE OVERALL GOAL: INCREASING
DIALECTICAL BEHAVIOR PATTERNS / 120 DIALECTICAL THINKING 120 /
DIALECTICAL THINKING AND COGNITIVE THERAPY 123 / DIA- LECTICAL BEHAVIOR
PATTERNS: BALANCED LIFESTYLE 124 PRIMARY BEHAVIORAL TARGETS / 124
DECREASING SUICIDAL BEHAVIORS 124 / DECREASING THERAPY-INTERFERING
BEHAVIORS 129 / DECREASING BEHAVIORS THAT INTERFERE WITH QUALITY OF LIFE
141 / INCREASING BE- HAVIORAL SKILLS 143 / DECREASING BEHAVIORS RELATED
TO POSTTRAUMATIC STRESS 155 / INCREASING RESPECT FOR SELF 160 SECONDARY
BEHAVIORAL TARGETS / 160
INCREASING EMOTION MODULATION; DECREASING EMOTIONAL REACTIVITY 161 /
INCREAS- ING SELF-VALIDATION; DECREASING SELF-INVALIDATION 161 /
INCREASING REALISTIC DECI- SION MAKING AND JUDGMENT; DECREASING
CRISIS-GENERATING BEHAVIORS 162 / INCREASING EMOTIONAL EXPERIENCING;
DECREASING INHIBITED GRIEVING 162 / INCREAS- ING ACTIVE PROBLEM SOLVING;
DECREASING ACTIVE-PASSIVITY BEHAVIORS 162 / INCREAS- ING ACCURATE
COMMUNICATION OF EMOTIONS AND COMPETENCIES; DECREASING MOOD
DEPENDENCY OF BEHAVIOR 163 CONCLUDING COMMENTS / 164 NOTE / 164
IMAGE 3
CONTENTS XIII
6. STRUCTURING TREATMENT AROUND TARGET BEHAVIORS: 165 WHO TREATS WHAT
AND WHEN THE GENERAL THEME: TARGETING DIALECTICAL BEHAVIORS / 166 THE
HIERARCHY OF PRIMARY TARGETS / 166
TREATMENT TARGETS AND SESSION AGENDA 167 / TREATMENT TARGETS AND MODES
OF THER- APY 167 / THE PRIMARY THERAPIST AND RESPONSIBILITY FOR MEETING
TARGETS 168 PROGRESS TOWARD TARGETS OVER TIME / 168 PRETREATMENT STAGE:
ORIENTATION AND COMMITMENT 169 / STAGE 1: ATTAINING BASIC
CAPACITIES 169 / STAGE 2: REDUCING POSTTRAUMATIC STRESS 170 / STAGE 3:
INCREASING SELF-RESPECT AND ACHIEVING INDIVIDUAL GOALS 172 SETTING
PRIORITIES WITHIN TARGET CLASSES IN OUTPATIENT INDIVIDUAL THERAPY / 173
DECREASING SUICIDAL BEHAVIORS 174 / DECREASING THERAPY-INTERFERING
BEHAVIORS 175 / DECREASING QUALITY-OF-LIFE-INTERFERING BEHAVIORS 177 /
INCREASING BEHAVIORAL SKILLS 178 / REDUCING POSTTRAUMATIC STRESS 179 /
INCREASING SELF-RESPECT AND ACHIEVING INDIVIDUAL GOALS 179 / USING
TARGET PRIORITIES TO ORGANIZE SESSIONS 180 / PATIENT AND THERAPIST
RESISTANCE TO DISCUSSING TARGET BEHAVIORS 181 / INDIVIDUAL THER- APY
TARGETS AND DIARY CARDS 184 SKILLS TRAINING: HIERARCHY OF TARGETS / 186
SUPPORTIVE PROCESS GROUPS: HIERARCHY OF TARGETS / 187 TELEPHONE CALLS:
HIERARCHY OF TARGETS / 188
CALLS TO THE PRIMARY THERAPIST 188 / CALLS TO SKILLS TRAINERS AND OTHER
THERAPISTS 190 TARGET BEHAVIORS AND SESSION FOCUS: WHO IS IN CONTROL? /
190 MODIFICATION OF TARGET HIERARCHIES IN OTHER SETTINGS / 191
RESPONSIBILITY FOR DECREASING SUICIDAL BEHAVIORS 192 / RESPONSIBILITY
FOR OTHER TARGETS 193 / SPECIFYING TARGETS FOR OTHER MODES OF TREATMENT
193 TURF CONFLICTS WITH RESPECT TO TARGET RESPONSIBILITIES / 194
CONCLUDING COMMENTS / 195
PART III. BASIC TREATMENT STRATEGIES
7. DIALECTICAL TREATMENT STRATEGIES 199
DEFINING DIALECTICAL STRATEGIES /201 BALANCING TREATMENT STRATEGIES:
DIALECTICS OF THE THERAPEUTIC RELATIONSHIP / 202 TEACHING DIALECTICAL
BEHAVIOR PATTERNS / 204 SPECIFIC DIALECTICAL STRATEGIES / 205
1. ENTERING THE PARADOX 205 / 2. THE USE OF METAPHOR 209 / 3. THE
DEVIL S ADVOCATE TECHNIQUE 212 / 4. EXTENDING 213 / 5. ACTIVATING WISE
MIND 214 / 6. MAKING LEMONADE OUT OF LEMONS 216 / 7. ALLOWING NATURAL
CHANGE 217/8. DIALECTICAL ASSESSMENT 218 CONCLUDING COMMENTS / 219 NOTES
/ 220
8. CORE STRATEGIES: PART I. VALIDATION 221
DEFINING VALIDATION / 222 WHY VALIDATE? / 225 EMOTIONAL VALIDATION
STRATEGIES / 226 1. PROVIDING OPPORTUNITIES FOR EMOTIONAL EXPRESSION 228
/
2. TEACHING EMOTION OBSERVATION AND LABELING SKILLS 230 / 3. READING
EMOTIONS 231 / 4. COMMUNICATING THE VALIDITY OF EMOTIONS 234
IMAGE 4
XIV CONTENTS
BEHAVIORAL VALIDATION STRATEGIES / 235 1. TEACHING BEHAVIOR OBSERVATION
AND LABELING SKILLS 235 / 2. IDENTIFYING THE SHOULD 237 / 3.
COUNTERING THE SHOULD 237 / 4. ACCEPTING THE SHOULD 238 / 5. MOVING
TO DISAPPOINT-
MENT 239 COGNITIVE VALIDATION STRATEGIES / 239 1. ELICITING AND
REFLECTING THOUGHTS AND ASSUMPTIONS 240 / 2. DISCRIMINATING FACTS FROM
INTERPRETATIONS 240 / 3. FIND-
ING THE KERNEL OF TRUTH 241 / 4. ACKNOWLEDGING WISE MIND 242 / 5.
RESPECTING DIFFERING VALUES 242 CHEERLEADING STRATEGIES / 242 1.
ASSUMING THE BEST 244 / 2. PROVIDING ENCOURAGEMENT 245
/ 3. FOCUSING ON THE PATIENT S CAPABILITIES 246 / 4. CONTRADICT-
ING/MODULATING EXTERNAL CRITICISM 247 / 5. PROVIDING PRAISE AND
REASSURANCE 247 / 6. BEING REALISTIC, BUT DEALING DIRECT- LY WITH FEARS
OF INSINCERITY 248 / 7. STAYING NEAR 249 CONCLUDING COMMENTS / 249
9. CORE STRATEGIES: PART II. PROBLEM SOLVING 250
LEVELS OF PROBLEM SOLVING / 250 FIRST LEVEL 250 / SECOND LEVEL 250 /
THIRD LEVEL 251 MOOD AND PROBLEM SOLVING / 251 OVERVIEW OF
PROBLEM-SOLVING STRATEGIES / 253 BEHAVIORAL ANALYSIS STRATEGIES / 254
1. DEFINING THE PROBLEM BEHAVIOR 255 / 2. CONDUCTING A CHAIN ANALYSIS
258 / 3. GENERATING HYPOTHESES ABOUT FACTORS CON- TROLLING BEHAVIOR 264
INSIGHT (INTERPRETATION) STRATEGIES /265
WHAT AND HOW TO INTERPRET: GUIDELINES FOR INSIGHT 266 / 1. HIGHLIGHTING
270 / 2. OBSERVING AND DESCRIBING RECURRENT PATTERNS 271 / 3. COMMENTING
ON IMPLICATIONS OF BEHAVIOR 271 / 4. ASSESSING DIFFICULTIES IN ACCEPTING
OR REJECTING HYPOTHESES 271 DIDACTIC STRATEGIES / 272
1. PROVIDING INFORMATION 273 / 2. GIVING READING MATERIALS 2 7 4 / 3.
GIVING INFORMATION TO FAMILY MEMBERS 274 SOLUTION ANALYSIS STRATEGIES /
275 1. IDENTIFYING GOALS, NEEDS, AND DESIRES 276 / 2. GENERATING
SOLUTIONS 278 / 3. EVALUATING SOLUTIONS 279 / 4. CHOOSING A SOLUTION TO
IMPLEMENT 281 / 5. TROUBLESHOOTING THE SOLU- TION 281 ORIENTING
STRATEGIES / 281
1. PROVIDING ROLE INDUCTION 282 / 2. REHEARSING NEW EXPEC- TATIONS 283
COMMITMENT STRATEGIES / 284 LEVELS OF COMMITMENT 284 / COMMITMENT AND
RECOMMITMENT 285 / THE NEED
FOR FLEXIBILITY 286 / 1. SELLING COMMITMENT: EVALUATING THE PROS AND
CONS 286 / 2. PLAYING THE DEVIL S ADVOCATE 286 / 3. FOOT- IN-THE-DOOR
AND DOOR-IN-THE-FACE TECHNIQUES 288 / 4. CON- NECTING PRESENT
COMMITMENTS TO PRIOR COMMITMENTS 289
/ 5. HIGHLIGHTING FREEDOM TO CHOOSE AND ABSENCE OF ALTER- NATIVES 289 /
6. USING PRINCIPLES OF SHAPING 290 / 7. GENERAT- ING HOPE: CHEERLEADING
290 / 8. AGREEING ON HOMEWORK 291 CONCLUDING COMMENTS / 291
IMAGE 5
CONTENTS XV
10. CHANGE PROCEDURES: PART I. CONTINGENCY PROCEDURES 292 (MANAGING
CONTINGENCIES AND OBSERVING LIMITS) THE RATIONALE FOR CONTINGENCY
PROCEDURES / 294 THE DISTINCTION BETWEEN MANAGING CONTINGENCIES AND
OBSERVING LIMITS 295 /
THE THERAPEUTIC RELATIONSHIP AS CONTINGENCY 296 CONTINGENCY MANAGEMENT
PROCEDURES / 297 ORIENTING TO CONTINGENCY MANGEMENT: TASK OVERVIEW 297 /
1. REINFORCING
TARGET-RELEVANT ADAPTIVE BEHAVIORS 301 / 2. EXTINGUISHING
TARGET-RELEVANT MALADAPTIVE BEHAVIORS 302 / 3. USING AVER- SIVE
CONSEQUENCES . . . WITH CARE 306 / DETERMINING THE POTENCY OF
CONSEQUENCES 314 / USING NATURAL OVER ARBITRARY CONSEQUENCES 317 /
PRINCI- PLES OF SHAPING 318 OBSERVING-LIMITS PROCEDURES / 319
RATIONALE FOR OBSERVING LIMITS 320 / NATURAL VERSUS ARBITRARY LIMITS 321
/ 1. MONITORING LIMITS 322 / 2. BEING HONEST ABOUT LIMITS 323 / 3.
TEMPORARILY EXTENDING LIMITS WHEN NEEDED 325 / 4. BEING CONSISTENTLY
FIRM 325 / 5. COMBINING SOOTHING, VALIDATING, AND PROBLEM SOLVING WITH
OBSERVING LIMITS 326 / DIFFICULT AREAS . FOR OBSERVING LIMITS WITH
BORDERLINE PATIENTS 326 CONCLUDING COMMENTS / 327
11. CHANGE PROCEDURES: PART II. SKILLS TRAINING, EXPOSURE, 329 COGNITIVE
MODIFICATION SKILLS TRAINING PROCEDURES / 329 ORIENTING AND COMMITTING
TO SKILLS TRAINING: TASK OVERVIEW 330 / SKILL AC-
QUISITION PROCEDURES 331 / SKILL STRENGTHENING PROCEDURES 334 / SKILL
GENERALIZATION PROCEDURES 337 EXPOSURE-BASED PROCEDURES / 343 ORIENTING
AND COMMITMENT TO EXPOSURE: TASK OVERVIEW 345 / 1. PROVIDING
NONREINFORCED EXPOSURE 347 / 2. BLOCKING ACTION TENDEN- CIES ASSOCIATED
WITH PROBLEM EMOTIONS 354 / 3. BLOCKING EX- PRESSIVE TENDENCIES
ASSOCIATED WITH PROBLEM EMOTIONS 356 / 4. ENHANCING CONTROL OVER
AVERSIVE EVENTS 357 / STRUCTURED
EXPOSURE PROCEDURES 358 COGNITIVE MODIFICATION PROCEDURES / 358
ORIENTING TO COGNITIVE MODIFICATION PROCEDURES 360 / CONTINGENCY
CLARIFI-
CATION PROCEDURES 361 / COGNITIVE RESTRUCTURING PROCE- DURES 364
CONCLUDING COMMENTS / 370 NOTE / 370
12. STYLISTIC STRATEGIES: BALANCING COMMUNICATION 371 RECIPROCAL
COMMUNICATION STRATEGIES / 372 POWER AND PSYCHOTHERAPY: WHO MAKES THE
RULES? 372 / 1. RESPONSIVENESS 373 / 2. SELF-DISCLOSURE 376 / 3. WARM
ENGAGEMENT 383 / 4.
GENUINENESS 388 / THE NEED FOR THERAPIST INVULNERABILITY 390 IRREVERENT
COMMUNICATION STRATEGIES / 393 DIALECTICAL STRATEGIES AND IRREVERENCE
393 / 1. REFRAMING IN AN UNORTHO- DOX MANNER 394 / 2. PLUNGING IN WHERE
ANGELS FEAR TO TREAD
3 9 5 / 3. USING A CONFRONTATIONAL TONE 396 / 4. CALLING THE PA- TIENT S
BLUFF 396 / 5. OSCILLATING INTENSITY AND USING SILENCE 396 / 6.
EXPRESSING OMNIPOTENCE AND IMPOTENCE 397 CONCLUDING COMMENTS / 397 NOTE
/ 398
IMAGE 6
XVI CONTENTS
13. CASE MANAGEMENT STRATEGIES: INTERACTING 399
WITH THE COMMUNITY ENVIRONMENTAL INTERVENTION STRATEGIES / 401 CASE
MANAGEMENT AND OBSERVING LIMITS 401 / CONDITIONS MANDATING ENVIRON-
MENTAL INTERVENTION 402 / 1. PROVIDING INFORMATION INDEPENDENT-
LY OF THE PATIENT 404 / 2. PATIENT ADVOCACY 404 / 3. ENTERING THE
PATIENT S ENVIRONMENT TO GIVE HER ASSISTANCE 405
CONSULTATION-TO-THE-PATIENT STRATEGIES / 406 RATIONALE AND SPIRIT OF
CONSULTATION TO THE PATIENT 407 / THE TREATMENT TEAM
VERSUS EVERYONE ELSE 408 / 1. ORIENTING THE PATIENT AND THE NET- WORK
TO THE APPROACH 409 / 2. CONSULTATION TO THE PATIENT ABOUT HOW TO MANAGE
OTHER PROFESSIONALS 411 / 3. CONSUL-
TATION TO THE PATIENT ABOUT HOW TO HANDLE FAMILY AND FRIENDS 419 /
ARGUMENTS AGAINST THE CONSULTATION APPROACH 421 THERAPIST
SUPERVISION/CONSULTATION STRATEGIES / 423 THE NEED FOR
SUPERVISION/CONSULTATION 424 / 1. MEETING TO CONFER ON
TREATMENT 426 / 2. KEEPING SUPERVISION/CONSULTATION AGREE- MENTS 428 /
3. CHEERLEADING 429 / 4. PROVIDING DIALECTICAL BALANCE 430 / WORKING OUT
PROBLEMS OF STAFF SPLITTING 431 / DEALING WITH UNETHICAL OR
DESTRUCTIVE THERAPIST BEHAVIOR 433 / KEEPING INFORMATION CONFIDEN- TIAL
434 CONCLUDING COMMENTS / 434
PART IV. STRATEGIES FOR SPECIFIC TASKS
14. STRUCTURAL STRATEGIES 437
CONTRACTING STRATEGIES: STARTING TREATMENT / 438 1. CONDUCTING A
DIAGNOSTIC ASSESSMENT 438 / 2. PRESENTING THE BIOSOCIAL THEORY OF
BORDERLINE BEHAVIOR 440 / 3. ORIENT- ING THE PATIENT TO TREATMENT 442 /
4. ORIENTING THE NETWORK TO TREATMENT 443 / 5. REVIEWING TREATMENT
AGREEMENTS AND LIMITS 444 / 6. COMMITTING TO THERAPY 444 / 7. CONDUCTING
ANALYSES OF MAJOR TARGET BEHAVIORS 446 / 8. BEGINNING TO DE- VELOP THE
THERAPEUTIC RELATIONSHIP 446 / CAVEATS IN THE REAL WORLD 447
SESSION-BEGINNING STRATEGIES / 448
1. GREETING THE PATIENT 449 / 2. RECOGNIZING THE PATIENT S CUR- RENT
EMOTIONAL STATE 449 / 3. REPAIRING THE RELATIONSHIP 450 TARGETING
STRATEGIES / 450 1. REVIEWING TARGET BEHAVIORS SINCE THE LAST SESSION
452 / 2.
USING TARGET PRIORITIES TO ORGANIZE SESSIONS 453 / 3. ATTEND- ING TO
STAGES OF THERAPY 453 / 4. CHECKING PROGRESS IN OTHER MODES OF THERAPY
453 SESSION-ENDING STRATEGIES / 454
1. PROVIDING SUFFICIENT TIME FOR CLOSURE 454 / 2. AGREEING ON HOMEWORK
FOR THE COMING WEEK 454 / 3. SUMMARIZING THE SESSION 455 / 4. GIVING THE
PATIENT A TAPE OF THE SESSION 455 / 5. CHEERLEADING 456 / 6. SOOTHING
AND REASSURING THE PA- TIENT 456 / 7. TROUBLESHOOTING 4 5 7 / 8.
DEVELOPING ENDING RITUALS 457 TERMINATING STRATEGIES / 457
1. BEGINNING DISCUSSION OF TERMINATING: TAPERING OFF SESSIONS 457 / 2.
GENERALIZING INTERPERSONAL RELIANCE TO THE SOCIAL NETWORK 458 / 3.
ACTIVELY PLANNING FOR TERMINATION 459 / 4. MAKING APPROPRIATE REFERRALS
460 CONCLUDING COMMENTS / 461
IMAGE 7
CONTENTS XVII
15. SPECIAL TREATMENT STRATEGIES 462
CRISIS STRATEGIES / 462 1. PAYING ATTENTION TO AFFECT RATHER THAN
CONTENT 463 / 2. EXPLORING THE PROBLEM NOW 463 / 3. FOCUSING ON PROBLEM
SOLVING 465 / 4. FOCUSING ON AFFECT TOLERANCE 467 / 5. OBTAIN-
ING COMMITMENT TO A PLAN OF ACTION 468 / 6. ASSESSING SUI- CIDE
POTENTIAL 468 / 7. ANTICIPATING A RECURRENCE OF THE CRISIS RESPONSE 468
SUICIDAL BEHAVIOR STRATEGIES / 468 THE THERAPEUTIC TASK 469 / PREVIOUS
SUICIDAL BEHAVIORS: PROTOCOL FOR THE PRIMARY THERAPIST 469 / THREATS OF
IMMINENT SUICIDE OR PARASUICIDE: PROTOCOL FOR THE PRIMARY THERAPIST 476
/ ON- GOING PARASUICIDAL ACT: PROTOCOL FOR THE PRIMARY THERAPIST 490 /
SUICIDAL BEHAVIORS: PROTOCOL FOR COLLATERAL THERAPISTS 492 / PRINCIPLES
OF RISK MANAGEMENT WITH SUICIDAL PATIENTS 493 THERAPY-INTERFERING
BEHAVIOR STRATEGIES / 495
1. DEFINING THE INTERFERING BEHAVIOR 495 / 2. CONDUCTING A CHAIN
ANALYSIS OF THE BEHAVIOR 495 / 3. ADOPTING A PROBLEM- SOLVING PLAN 496 /
4. RESPONDING TO THE PATIENT WHO REFUSES TO MODIFY INTERFERING BEHAVIOR
497 TELEPHONE STRATEGIES / 497
1. ACCEPTING PATIENT-INITIATED PHONE CALLS UNDER CERTAIN CONDITIONS 498
/ 2. SCHEDULING PATIENT-INITIATED PHONE CALLS 502 / 3. INITIATING
THERAPIST PHONE CONTACTS 502 / 4. GIVING FEEDBACK ABOUT PHONE CALL
BEHAVIOR DURING SESSIONS 502 / THERAPIST AVAILABILITY AND MANAGEMENT OF
SUICIDAL RISK 503 ANCILLARY TREATMENT STRATEGIES / 504
1. RECOMMENDING ANCILLARY TREATMENT WHEN NEEDED 504 / 2. RECOMMENDING
OUTSIDE CONSULTATION FOR THE PATIENT 505 / MEDICATION PROTOCOL 507 /
HOSPITAL PROTOCOL 510 RELATIONSHIP STRATEGIES / 514
1. RELATIONSHIP ACCEPTANCE 515 / 2. RELATIONSHIP PROBLEM SOLV- ING 517 /
3. RELATIONSHIP GENERALIZATION 519 CONCLUDING COMMENTS / 519 APPENDIX
15.1 SCALE POINTS FOR LETHALITY ASSESSMENT / 519 NOTE / 523
APPENDIX: SUGGESTED READING 524
REFERENCES 527
INDEX 547
|
| any_adam_object | 1 |
| author | Linehan, Marsha 1943- |
| author_GND | (DE-588)133627918 |
| author_facet | Linehan, Marsha 1943- |
| author_role | aut |
| author_sort | Linehan, Marsha 1943- |
| author_variant | m l ml |
| building | Verbundindex |
| bvnumber | BV011034651 |
| callnumber-first | R - Medicine |
| callnumber-label | RC569 |
| callnumber-raw | RC569.5.B67 |
| callnumber-search | RC569.5.B67 |
| callnumber-sort | RC 3569.5 B67 |
| callnumber-subject | RC - Internal Medicine |
| classification_rvk | CU 3600 CU 4000 CU 8500 YH 6500 |
| ctrlnum | (OCoLC)27854187 (DE-599)BVBBV011034651 |
| dewey-full | 616.85/8520651 |
| dewey-hundreds | 600 - Technology (Applied sciences) |
| dewey-ones | 616 - Diseases |
| dewey-raw | 616.85/8520651 |
| dewey-search | 616.85/8520651 |
| dewey-sort | 3616.85 78520651 |
| dewey-tens | 610 - Medicine and health |
| discipline | Psychologie Medizin |
| format | Book |
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| id | DE-604.BV011034651 |
| illustrated | Not Illustrated |
| indexdate | 2024-07-09T18:02:57Z |
| institution | BVB |
| isbn | 0898621836 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-007389391 |
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| physical | XVII, 558 S. |
| publishDate | 1993 |
| publishDateSearch | 1993 |
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| publisher | Guilford Press |
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| series2 | Diagnosis and treatment of mental disorders |
| spelling | Linehan, Marsha 1943- Verfasser (DE-588)133627918 aut Cognitive-behavioral treatment of borderline personality disorder Marsha M. Linehan Cognitive-behavioral treatment of borderline personality disorder New York [u.a.] Guilford Press 1993 XVII, 558 S. txt rdacontent n rdamedia nc rdacarrier Diagnosis and treatment of mental disorders For the average clinician, clinic, or inpatient facility, individuals with borderline personality disorder often represent the most difficult and insoluble cases. The first volume to provide strategies proven effective in controlled clinical trials, this book is a comprehensive, integrated approach to therapy with this population. Marsha Linehan presents specific guidelines that creatively combine the best elements of behavioral, psychoanalytic, strategic, and other commonly employed modalities. A clinical innovator, she has analyzed the aspects of borderline into their component parts and developed a systematized approach to each of them. The first section of the book presents an overview of the disorder and lays out a theoretical framework to guide the therapy. The second describes in detail how to assess borderline patients and how to organize and prioritize treatment goals and behavioral targets The core of the treatment is the balance of acceptance and change strategies, both within each therapy interaction and over time. For problem solving with borderline personality disorder, the book provides specific strategies for contingency management, exposure, cognitive modification, and skills training. The last component is further elucidated in the companion Skills Training Manual, which programmatically details procedures and includes client handouts for step-by-step implementation. Finally, to enhance interpersonal communication, Dr. Linehan presents three case management sets: consultation to the patient, environmental intervention, and consultation to the therapist. Addressing the most stressful patient behaviors that clinicians encounter, the book includes a step-by-step outline for assessing suicide risk, managing suicide threats, and working with chronic suicidal behavior Integrative approaches for such specific problems as crises, noncompliance, and breakdowns in the therapeutic relationship are also discussed. Lucidly detailing effective techniques that can be replicated in clinical practice, this volume illuminates the internal experience of borderline individuals and provides clinicians with practical clinical tools for working with them. As such, it is an invaluable resource for all professionals who work with this difficult-to-treat population Borderline persoonlijkheid gtt Cognitieve therapie gtt Thérapie cognitive État-limite (Psychiatrie) - Traitement Behavior Therapy Borderline Personality Disorder therapy Borderline personality disorder Treatment Cognitive Therapy Cognitive therapy Kognitive Verhaltenstherapie (DE-588)4114250-0 gnd rswk-swf Kognitive Psychotherapie (DE-588)4164472-4 gnd rswk-swf Borderline-Persönlichkeitsstörung (DE-588)4007720-2 gnd rswk-swf Gruppentherapie (DE-588)4072158-9 gnd rswk-swf Therapie (DE-588)4059798-2 gnd rswk-swf Übungsprogramm (DE-588)4352126-5 gnd rswk-swf Borderline-Persönlichkeitsstörung (DE-588)4007720-2 s Kognitive Psychotherapie (DE-588)4164472-4 s DE-604 Kognitive Verhaltenstherapie (DE-588)4114250-0 s Übungsprogramm (DE-588)4352126-5 s 1\p DE-604 Therapie (DE-588)4059798-2 s 2\p DE-604 Gruppentherapie (DE-588)4072158-9 s 3\p DE-604 SWB Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007389391&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis 1\p cgwrk 20201028 DE-101 https://d-nb.info/provenance/plan#cgwrk 2\p cgwrk 20201028 DE-101 https://d-nb.info/provenance/plan#cgwrk 3\p cgwrk 20201028 DE-101 https://d-nb.info/provenance/plan#cgwrk |
| spellingShingle | Linehan, Marsha 1943- Cognitive-behavioral treatment of borderline personality disorder Borderline persoonlijkheid gtt Cognitieve therapie gtt Thérapie cognitive État-limite (Psychiatrie) - Traitement Behavior Therapy Borderline Personality Disorder therapy Borderline personality disorder Treatment Cognitive Therapy Cognitive therapy Kognitive Verhaltenstherapie (DE-588)4114250-0 gnd Kognitive Psychotherapie (DE-588)4164472-4 gnd Borderline-Persönlichkeitsstörung (DE-588)4007720-2 gnd Gruppentherapie (DE-588)4072158-9 gnd Therapie (DE-588)4059798-2 gnd Übungsprogramm (DE-588)4352126-5 gnd |
| subject_GND | (DE-588)4114250-0 (DE-588)4164472-4 (DE-588)4007720-2 (DE-588)4072158-9 (DE-588)4059798-2 (DE-588)4352126-5 |
| title | Cognitive-behavioral treatment of borderline personality disorder |
| title_alt | Cognitive-behavioral treatment of borderline personality disorder |
| title_auth | Cognitive-behavioral treatment of borderline personality disorder |
| title_exact_search | Cognitive-behavioral treatment of borderline personality disorder |
| title_full | Cognitive-behavioral treatment of borderline personality disorder Marsha M. Linehan |
| title_fullStr | Cognitive-behavioral treatment of borderline personality disorder Marsha M. Linehan |
| title_full_unstemmed | Cognitive-behavioral treatment of borderline personality disorder Marsha M. Linehan |
| title_short | Cognitive-behavioral treatment of borderline personality disorder |
| title_sort | cognitive behavioral treatment of borderline personality disorder |
| topic | Borderline persoonlijkheid gtt Cognitieve therapie gtt Thérapie cognitive État-limite (Psychiatrie) - Traitement Behavior Therapy Borderline Personality Disorder therapy Borderline personality disorder Treatment Cognitive Therapy Cognitive therapy Kognitive Verhaltenstherapie (DE-588)4114250-0 gnd Kognitive Psychotherapie (DE-588)4164472-4 gnd Borderline-Persönlichkeitsstörung (DE-588)4007720-2 gnd Gruppentherapie (DE-588)4072158-9 gnd Therapie (DE-588)4059798-2 gnd Übungsprogramm (DE-588)4352126-5 gnd |
| topic_facet | Borderline persoonlijkheid Cognitieve therapie Thérapie cognitive État-limite (Psychiatrie) - Traitement Behavior Therapy Borderline Personality Disorder therapy Borderline personality disorder Treatment Cognitive Therapy Cognitive therapy Kognitive Verhaltenstherapie Kognitive Psychotherapie Borderline-Persönlichkeitsstörung Gruppentherapie Therapie Übungsprogramm |
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