Table 1 Comparison of treatments for borderline patients when suicide is the complaint
Topic | GAPPC common factors | BSSG candidate interventions | Links common principles | Bateman common characteristics |
|---|---|---|---|---|
Treatment structure | Negotiate a frame for treatment in pre-treatment phase to clarify responsibility and establish a crisis plan | Clear treatment framework. | Increased activity of the therapist to provide a stable framework | Active stance by the therapist to validate and demonstrate empathy, generate attachment and create alliance |
Defined strategy for managing suicide crises | ||||
Patient role | Recognize and insist on patient’s responsibilities | Foster “greater sense of self agency” | Encourage increased activity, proactivity and self-agency for patient | |
Therapist behavior | Provide the therapist with coherent conceptualization of meaning of behavior and interventions | Use theory and associated interventions to guide and ground treatment | Promote confidence based on model of understanding. | Manual provides recommended interventions. |
Connection between action and feelings | Focus on connections between acts and feelings. | |||
Explain model of pathology to patient to promote cognitive coherence. | ||||
Therapeutic relationship | Use the therapeutic relationship and attachment to the therapist to engage suicide | Generate attachment, as above | ||
Handling threat of suicide | Prioritize suicide as a topic to address in sessions | Empathic validation plus prioritization of self destructive behaviors | ||
Support for therapist | Provide support for the therapist | Consultation, supervision, attention to countertransference | Manual supports the therapist |