The primary form of treatment is outpatient psychotherapy 1–2 sessions a week over a time span of 1–3 years.|
Disorder-specific inpatient psychotherapy
(In a psychotherapeutic ward with a treatment concept adapted specifically for BPD) (Elective treatment according to individual indication).
Treatment of personality syndromes may often involve multidisciplinary teams and multimodal programs.|
Specialist services should be able to offer one or more of the evidence-based psychotherapies for borderline personality disorder.
There is insufficient empirical support for choosing between short-term or long-term psychotherapies.
It is good practice to offer either multimodal treatment programs including psychotherapy or unimodal psychotherapy to patients with borderline personality disorder.|
It is good practice to offer either short-term psychotherapy (< 12 months) or long-term psychotherapy (≥ 12 months).
It is good practice to consider monitoring psychotherapy offered to patients with borderline personality disorder.
Some psychotherapeutic approaches can effectively relieve the symptoms and distress of patients as well as promote adaptation and enhance functioning.|
Treatment should be delivered as outpatient treatment as much as possible, and inpatient treatment should be mostly day hospital treatment.
|Catalonia (2011)||BPD||Recommend the use of DBT for treatment and (with less evidence) the use of MBT and Schema Focused Therapy|
Four treatments are recommended as good practice: dialectic-behavioral therapy (DBT), mentalisation-based therapy (MBT), schema therapy/ schema-focused and transference-focused therapy (TFP).|
DBT treatment shows better empirical evidence than MBT, schema-focused therapy and TFP for BPD.
|British (BPD) (2009)||BPD||
When providing psychological treatment for people with borderline personality disorder, especially those with multiple comorbidities and/or severe impairment, the following service characteristics should be in place:|
- An explicit and integrated theoretical approach used by both the treatment team and the therapist, which is shared with the service user
- Structured care in accordance with this guideline
- Provision for therapist supervision.
- Although the frequency of psychotherapy should be adapted to the person’s needs and context of living, twice-weekly sessions may be considered.
Do not use brief psychotherapeutic interventions (of less than 3 month’s duration) specifically for borderline personality disorder or for the individual symptoms of the disorder.
|British (2009)||ASPD||For people with antisocial personality disorder, including those with substance misuse problems, in community and mental health services, consider offering group-based cognitive and behavioural interventions, in order to address problems such as impulsivity, interpersonal difficulties and antisocial behaviour.|
Several individual ambulatory psychotherapies are effective in treating people with a personality disorder.|
There is evidence that therapies that have been shown effective in treating Axis I disorders without a personality disorder are also effective in treating people who also have a personality disorder.
There is evidence that treating people with a personality disorder with psychotherapy is cost effective compared to treatment as usual and no therapy