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The impact of dialectical behavior therapy on a select group of clients diagnosed with borderline personality disorder: a case study approach

12 December 1998


Over the past decade, Marsha Linehan, Ph.D., developed a manualized treatment for chronically parasuicidal borderline clients called Dialectical Behavior Therapy (DBT). DBT addresses the dysnmctional personality patterns of clients diagnosed with borderline personality disorder (BPD) based on a biosocial theory of development. The treatment attempts to address five problem areas Linehan believes to be primary in the dysfunctional thoughts, feelings and behaviors of clients diagnosed with BPD. The following case study attempts to clarify the therapeutic impact of one DBT program on nine clients who agreed to participate in this study. While definitive answers to the, question of effectiveness are not offered, as the case study approach provides information regarding only a select few, the subjective meanings and experiences of these nine clients are explored in the context of their treatment. Relationships between clients' felt-experience regarding the effectiveness of the Program and the treatment provider's impression of progress are explored. Other relationships, such as: the ongoing experiences of symptoms in a variety of clinical areas and the clients' felt-improvement; and severity of pre-program flU1ctioning compared to progress in the program (both felt-improvement and treatment provider'S impression) were considered. While each participant acknowledged some felt-improvement, the nine clients were shown to be at different stages of integrating DBT into their lives.


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