Borderline Personality Disorder (BPD) is a mental illness that can make it difficult for people to feel safe in their relationships with other people, to have healthy thoughts and beliefs about themselves, and to control their emotions and impulses. People with BPD may experience distress in their work, family and social life, and may harm themselves. Having BPD is not the person’s fault – it is a condition of the brain and mind.
Research has not yet discovered how exactly how a person develops BPD, but it probably involves a combination of biological factors (such as genetics) and experiences that happen to a person while growing up (such as trauma in early life). For most people with BPD, symptoms begin during adolescence or as a young adult, but tend to improve during adult life.
For many people with BPD, their goals for treatment involve managing their emotions, finding purpose in life, and building better relationships. Many people with BPD have experienced significant trauma, either in the past or in their daily lives, so they need health care that makes them feel safe while they recover.
It is important to remember that BPD is a treatable condition, and that many people recover from BPD.
According to the National Health and Medical Research Council’s 2012 publication, Clinical Practice Guidelines for the Management of Borderline Personality Disorder, people with BPD should be provided with structured psychological therapies that are specifically designed for BPD, and conducted by one or more health professionals who are adequately trained and supervised. Here at The Glow Centre we pride ourselves on our clinicians’ high level of training and supervision in treating BPD using psychological treatment.
The psychological therapies that have the greatest evidence base for treating BPD are Dialectical Behaviour Therapy (DBT), Schema-Focused Therapy (SFT), Mentalisation Based Therapy (MBT), and Transference Focused Psychotherapy (TFP).
A number of clinicians at The Glow Centre have special interest and special training in treatments for BPD. We have extensive training and experience in both SFT and DBT.
DBT has been evaluated in more clinical research than any other psychological therapy for BPD. At The Glow Centre, DBT is our treatment of choice for BPD.
DBT was first developed in the 1990s by Marsha Linehan. It was the first treatment designed specifically to target the difficulties experienced by people with BPD, and to combine traditional change-focused therapy with the philosophy of acceptance of things as they are in the moment. Standard comprehensive DBT or “fully adherent” DBT programs involve weekly individual therapy, weekly skills training (usually in a group), between-session skills coaching (“phone coaching”), and therapist participation in a consultation team. These are the four modes of DBT. Please note: standard comprehensive DBT is currently not available at The Glow Centre.
Traditional DBT is undertaken for 6-12 months. Over time, DBT has been applied to many different populations, and there have been some adaptations of the model such as standalone skills training, and shortened versions of DBT.
It is important to note that the strongest evidence base is for standard comprehensive DBT including all four modes. Current evidence shows that standard DBT is associated with improvements in anger, depression, anxiety, self-harm, suicidal behaviours, and general wellbeing. Evidence is emerging into how helpful the adaptations of DBT can be, including that skills training alone is associated with improvements in BPD symptoms, anger, depression and anxiety.
In keeping with our value of clinical excellence, DBT is our treatment of choice for BPD. We offer a range of DBT-informed interventions. When someone is referred to us for DBT, we perform a thorough assessment and develop an individualised treatment plan in collaboration with our client, depending on the level of intensity that each requires.
Individual therapy with a DBT clinician
A number of our clinicians provide individual therapy, which can draw on the principles and protocols of DBT. In individual therapy, a DBT-informed approach can be taken, incorporating the fundamental principles of DBT including validation, a behavioural approach, and improving skills. Frequency of your individual therapy will depend on your individual treatment plan.
It is important to note that individual therapy with a DBT clinician is not “doing DBT”, as doing DBT involves undertaking all four modes of a standard program. At The Glow Centre, individual therapy with a DBT clinician can be undertaken on its own, or in combination with skills training.
Skills training groups
We also offer DBT skills training groups, either alone or in combination with individual therapy. Skills training is offered in groups of up to 8 participants.
Due to current COVID-19 social distancing requirements, our skills training groups are offered via telehealth.
Our skills training groups are offered in modules as per Marsha Linehan’s guidelines. The structure and outline of skills groups are as follows:
Distress Tolerance skills – an 8-week module
Emotion Regulation skills – a 9-week module
Interpersonal Effectiveness skills – a 7-week module.
Skills training groups are not therapy groups. They are more like a classroom setting, in which the DBT therapist teaches and explains skills, participants are assigned homework to complete before the next session, and homework is reviewed at each session.
Standard comprehensive DBT program
At The Glow Centre, we are not currently offering a standard comprehensive DBT program.
The DBT PE protocol
At The Glow Centre, we have two of only a handful of clinicians in Australia who have undertaken training in delivering DBT PE. DBT PE is the second stage of treatment for people with BPD, which targets their symptoms of PTSD.
If you are unsure which of the above you would be best suited for, we would suggest to make an appointment with one of our DBT clinicians so that they can undertake a DBT assessment and help develop an individualised DBT treatment plan.
The clinician can make recommendations on what will best meet your needs (whether it be skills groups, individual therapy, or a combination of these). A DBT assessment is charged at the rate of an individual one-on-one session.