Borderline Personality Disorder, Second Edition : a Clinical Guide

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Cover; Contents; About the Authors; Introduction; 1 The Borderline Diagnosis; Origins of the Diagnosis; Shifts in the Borderline Construct: From Organization to Syndrome to Disorder; Epidemiology; An Explication of the DSM-IV Criteria; A Clinical Synthesis: Intolerance of Aloneness; Misuses of the Borderline Diagnosis; The Behavioral Specialty: Self-Injurious Behavior; Use of the Diagnosis in Adolescents; How to Explain the Diagnosis; Summary; References; 2 Differential Diagnosis: Overlaps, Subtleties, and Treatment Implications; Overall Function. The Changing Construct: From Schizophrenia to Depression to Posttraumatic Stress Disorder to Bipolar DisorderComorbidity and Differential Diagnosis; Summary; References; 3 Overview of Treatment; Historical Overview; Generic Therapeutic Processes and the Functions They Serve; Multiple Modalities and Step-Down Services: An Overview; Sociotherapies; Establishing Goals: The Expectable Sequence of Change; Changes Within Four Spheres; The Initial Structuring of Treatment; Types and Sequence of Therapeutic Alliance; Countertransference; Summary; References; 4 Case Management: The Primary Clinician. QualificationsResponsibilities; Liability Issues; Relationship Management; Managing Safety; Responding to Recurrent Suicidality: The Principle of False Submission; Implementing Changes; Boundaries, Violations, and Setting Limits; Splits, Splitting, and the Virtues of Split Treatments; Giving, Receiving, and Participating in Supervision; Summary; References; 5 Levels of Care: Indications, Structure, Staffing; Selecting or Changing a Level of Care; Level IV: Hospital Treatment-Makes Therapy Possible; Level III: Residential/Partial Hospital Care/Day Treatment-Basic Socialization. Level II: Intensive Outpatient Care-Behavioral ChangeLevel I: Outpatient Care-Interpersonal Growth; Summary; References; 6 Pharmacotherapy: Clinical Practices; History; Overall Role of Medications; Getting Started; The Prescribing Psychiatrist's Role; Symptom Chasing; Attitudes, Meanings, and Attributions; Transference-Countertransference Issues; Contraindications and Discontinuance; Summary; References; 7 Pharmacotherapy: Selection of Medications; Pharmacotherapy Models; The Symptom-Targeted Model; Summary; References; 8 Family Interventions and Therapies; History. Therapists and CountertransferencesGetting Started: Overcoming Resistance; Phase 1: Initial Family Meetings; Phase 2: Establishing an Alliance; Phase 3: Psychoeducational Family Therapy; Phase 4: Psychodynamic Family Therapy; Marital or Couples Therapy; Summary; References; 9 Group Therapy; Indications; Engaging Patients and the Primary Clinician's Role; Skills Training Groups; Psychodynamic Group Therapies; Group Structure; Common Problems; Summary; References; 10 Individual Psychotherapies: Getting Started; Introduction: Prerequisites; Getting Started