"Marsha Linehan's tremendously in-depth and informative book and its companion skills-training manual offer a needed guide to the cognitive-behavioral treatment of borderline personality disorder....Her method has become so widely used by clinicians that the experts in psychosocial treatments consider it one of the best....Marsha Linehan's methods are highly eclectic because they are empirically based; they have been fashioned to fit what works best for borderline patients."—Lester Luborsky, PhD"Dr. Linehan's approach is sensible, pragmatic, and effective. Most importantly, it offers the therapist a humane and sensitive perspective on persons with Borderline Personality Disorder. In short, it treats both the therapist and the client in a fashion that produces results."—Mark Ciocca, PhD, Central New Hampshire Community Mental Health Center"...user-friendly manual well grounded in principle, detailed in its strategies, and exportable to a wide range of treatment settings."—Charles R. Swenson, MD, New York Hospital, Westchester Division
Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., McDavid, J., Comtois, K. A., & Murray-Gregory, A. M. (2015). Dialectical Behavior Therapy for high suicide risk in borderline personality disorder: A component analysis. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2014.3039.
Skills Training Manual for Treating Borderline Personality Disorder Marsha M. Linehan
Neacsiu, A. D., Lungu, A., Harned, M. S., Rizvi, S. L., & Linehan, M. M., (2014). Impact of dialectical behavior therapy versus community treatment by experts on emotional experience, expression, and acceptance in borderline personality disorder, Behavior Research and Therapy, 53, 47-64.
Bedics, J. D., Atkins, D.C., Comtois, K. A., & Linehan, M. M. (2012). Weekly ratings of the therapeutic relationship and introject during the course of dialectical behavior therapy for the treatment of borderline personality disorder. Psychotherapy: Theory, Research, Practice, Training, 29(2), 231-240.
Bedics, J. D., Atkins, D. C., Comtois, K. A., & Linehan, M. M. (2012). Treatment differences in the therapeutic relationship and introject during a 2-year randomized controlled trial of dialectical behavior therapy versus non-behavioral psychotherapy experts for borderline personality disorder. Journal of Consulting and Clinical Psychology, 80(1) 66-77.
Harned, M. S., Chapman, A. L., Dexter-Mazza, E. T., Murray, A., Comtois, K. A., & Linehan, M. M. (2008). Treating co-occurring Axis I disorders in chronically suicidal women with borderline personality disorder: A 2-year randomized trial of dialectical behavior therapy versus Community Treatment by Experts. Journal of Consulting and Clinical Psychology, 76(6), 1068-1075.
Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., Korslund, E., Tutek, D. A., Reynolds, S. K., & Lindenboim, N. (2006). Two-year randomized trial and follow-up of dialectical behavior therapy vs. therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63(7), 757-766.
Linehan, M. M., Dimeff, L. A., Reynolds, S. K., Comtois, K. A., Shaw-Welch, S., Heagerty, P., & Kivlahan, D. R. (2002). Dialectical behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug and Alcohol Dependence, 67(1), 13-26.
Linehan, M. M., Schmidt, H., Dimeff, L. A., Craft, J. C., Kanter, J., Comtois, K. A. (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. The American Journal on Addictions, 8(4), 279-292.
Linehan, M. M., McDavid, J., Brown, M. Z., Sayrs, & J. H. R., Gallop, R. J. (2008). Olanzapine plus dialectical behavior therapy for women with high irritability who meet criteria for borderline personality disorder: A double blind, placebo-controlled pilot study. Journal of Clinical Psychiatry, 69, 999-1005.
Harned, M. S., Ruork, A. K., Liu, J., & Tkachuck, M. A. (2015). Emotional activation and habituation during imaginal exposure for PTSD among women with borderline personality disorder. Journal of Traumatic Stress, 28, 253-257.
Harned, M. S., Korslund, K. E., & Linehan, M. M. (2014). A pilot randomized controlled trial of Dialectical Behavior Therapy with and without the Dialectical Behavior Therapy Prolonged Exposure protocol for suicidal and self-injuring women with borderline personality disorder and PTSD. Behaviour Research and Therapy, 55, 7-1.
Harned, M. S., Tkachuck, M. A., & Youngberg, K. A. (2013). Treatment preference among suicidal and self-injuring women with borderline personality disorder and PTSD. Journal of Clinical Psychology, 69,749-761.
Harned, M. S., Korslund, K. E., Foa, E. B., & Linehan, M. M. (2012). Treating PTSD in suicidal and self-injuring women with borderline personality disorder: Development and preliminary evaluation of a dialectical behavior therapy prolonged exposure protocol. Behaviour Research and Therapy, 50(6), 381-386.
Harned, M. S., Jackson, S. C., Comtois, K. A., & Linehan, M. M. (2010). Dialectical behavior therapy as a precursor to PTSD treatment for suicidal and/or self-injuring women with borderline personality disorder. Journal of Traumatic Stress, 23(4), 421-429.
Chen, E. Y., Matthews, L., Allen, C., Kuo, J. R, & Linehan, M. M. (2008). Dialectical behavior therapy for clients with binge-eating disorder or bulimia nervosa and borderline personality disorder. International Journal of Eating Disorders, 41(6), 505-512.
Bedics, J. D., Atkins, D. C., Harned, M. S., & Linehan, M. M. (2015). The therapeutic alliance as a predictor of outcome in dialectical behavior therapy versus nonbehavioral psychotherapy by experts for borderline personality disorder. Psychotherapy. Mar; 52(1):67-77.
*Neacsiu, A. D., Rizvi, S. L., Linehan, M. M. (2010). Dialectical behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder. Behaviour Research and Therapy, 48, 832-839.
Salsman, N. L., & Linehan, M. M. (2012). An investigation of the relationships among negative affect, difficulties in emotion regulation, and features of borderline personality disorder. Journal of Psychopathology and Behavioral Assessment, 34(2), 260-267.
Smoski, M. J., Salsman, N., Wang, L., Smith, V., Lynch, T. R., Dager, S., LaBar, K. S., & Linehan, M. M. (2011). Functional imaging of emotion reactivity in opiate-dependent borderline personality disorder. Personality Disorders: Theory, Research, and Treatment. Advance online publication. doi:10.1037/a0022228
Harned, M. S., Rizvi, S. L., & Linehan, M. M. (2010). The impact of co-occurring posttraumatic stress disorder on suicidal women with borderline personality disorder. American Journal of Psychiatry, 167(10), 1210-1217.
Chapman, A. L., Derbidge, C. M., Cooney, E., Hong, P. Y., & Linehan, M. M. (2009). Temperament as a prospective predictor of self-injury among patients with borderline personality disorder. Journal of Personality Disorder, 23(2), 122-140.
Berking, M., Neacsiu, A., Comtois, K. A., & Linehan, M. M. (2009). The impact of experiential avoidance on the reduction of depression in treatment for borderline personality disorder. Behaviour Research and Therapy, 47(8), 663-670.
*Brown, M. Z., Linehan, M. M., Comtois, K. A., Murray, A., & Chapman, A. L. (2009). Shame as a prospective predictor of self-inflicted injury in borderline personality disorder: A multi-modal analysis. Behaviour Research and Therapy, 47(10), 815-22.
*Welch, S. S., Linehan, M. M., Sylvers, P., Chittams, J., & Rizvi, S. L. (2008). Emotional responses to self-injury imagery among adults with borderline personality disorder. Journal of Consulting and Clinical Psychology, 76(1), 45-51.
Brown, M., Linehan, M. M., & Comtois, K. (2002). Reasons for suicide attempts and non-suicidal self-injury in women with borderline personality disorder. Journal of Abnormal Psychology, 111(1), 198-202.
Wagner, A.W., & Linehan, M. M. (1994). Relationship between childhood sexual abuse and topography of parasuicide among women with borderline personality disorder. Journal of Personality Disorders, 8(1), 1-9.
Linehan, M. M., Cochran, B. N., Mar, C. M., Levensky, E. R., & Comtois, K. A. (2000). Therapeutic burnout among borderline personality disordered clients and their therapists: Development and evaluation of two adaptations of the Maslach Burnout Inventory. Cognitive Behavioral Practice, 8(3), 329-337.
Understanding philosophy and theory are important because they determine therapist attitude toward the patient suffering from borderline personality disorder. This therapy is a combination of individual therapy and group skills trading. DBT is based on a dialectical world view, which has two meanings: that of the fundamental nature of reality and of the effective dialogue within relationships. Dialectics forms the basis of DBT.
Dichotomous, extreme thinking, characteristic of borderline personality disorder, is viewed as a failure of dialectics. The borderline is stuck in polarities, unable to move to synthesis. Three of these polarities cause particular difficulty in treatment:
One of the core tenets of the biopsychosocial theory of borderline personality disorder is that the heart of the disorder is emotional dysregulation. This is viewed as joint outcome of biological disposition and environmental interaction.
The bottom line is that borderline personality disorder is the combination of an overly sensitive and overreactive emotional system with an inability to inhibit the resulting strong emotional response. The disposition to emotional vulnerability is biologically based, although not necessarily genetically. Any deficit in the complex system of emotional regulation can lead to the difficulties of the borderline personality disorder patient.
This transactional view should not be used to diminish the importance of abusive environments in the etiology of borderline personality disorder. Research indicates up to 75% of those suffering from borderline personality disorder experienced some sexual abuse in childhood. It is unclear if the abuse is causative or if both the abuse and the disorder are both signs of the same dysfunctional, invalidating family pathology. 2ff7e9595c
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