title: Constructivist Simultaneous Treatment of Borderline Personality Disorder, Trauma, and Addiction Comorbidity: A Qualitative Case Study.
abstract: This qualitative case study explored one client's recovery from borderline personality disorder, trauma, and problem gambling. The client attended 18 months of integrative treatment and was followed for 5 years. The study included 106 data points of both client and therapist data. We identified three phases to treatment. First, alliance formation and normalization appeared as mechanisms, and the client experienced dependence. Second, working alliance and countertransference appeared as mechanisms, and the client experienced reduced gambling and suicidal ideation. Third, external controls and increased opportunity appeared as mechanisms, and "moving into the world" was the client experience. The findings give preliminary support to a phase-based constructivist treatment including trauma assessment to normalize self-feelings, countertransference work to support motivation for restraint, and case management principles to support continuity of change efforts.
authors.affiliation: Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway ayna.johansen@medisin.uio.no.|Centre for Study of Mind in Nature, University of Oslo, Oslo, Norway.
authors.forename: Ayna B
authors.initials: AB
authors.lastname: Johansen
authors.affiliation: Northeastern Illinois University, Chicago, USA.
authors.forename: Shedeh
authors.initials: S
authors.lastname: Tavakoli
authors.affiliation: Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.
authors.forename: Ingerid
authors.initials: I
authors.lastname: Bjelland
authors.affiliation: Wayne State University, Detroit, Miami, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Lumley
mesh_terms: D000328:Adult; D016739:Behavior, Addictive / Q000453:epidemiology / Q000628:therapy; D001883:Borderline Personality Disorder / Q000453:epidemiology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005715:Gambling / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D009042:Motivation; D036301:Qualitative Research; D060685:Sense of Coherence; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000628:therapy*; D059020:Suicidal Ideation
keywords: Norway; addiction; borderline personality; general inductive approach; qualitative case study; simultaneous treatment; trauma