What Works in the Treatment of Borderline Personality Disorder.
OBJECTIVE
This review summarizes advances in treatments for adults with borderline personality disorder (BPD) in the last 5 years.


RESULTS
Evidence-based advances in the treatment of BPD include a delineation of generalist models of care in contrast to specialist treatments, identification of essential effective elements of dialectical behavioral therapy (DBT), and the adaptation of DBT treatment to manage post-traumatic stress disorder (PTSD) and BPD. Studies on pharmacological interventions remain limited and have not provided evidence that any specific medications can provide stand-alone treatment.


CONCLUSIONS
The research on treatment in BPD is leading to a distillation of intensive packages of treatment to be more broadly and practically implemented in most treatment environments through generalist care models and pared down forms of intensive treatments (e.g., informed case management plus DBT skills training groups). Evidence-based integrations of DBT and exposure therapy for PTSD provide support for changing practices to simultaneously treat PTSD and BPD.
Harvard Medical School, McLean Hospital, 115 Mill St., Mail Stop 312, Belmont, MA 02478 USA.
Lois W
LW
Choi-Kain
Harvard Medical School, McLean Hospital, 115 Mill St., Mail Stop 312, Belmont, MA 02478 USA.
Ellen F
EF
Finch
Harvard Medical School, McLean Hospital, 115 Mill St., Mail Stop 312, Belmont, MA 02478 USA.
Sara R
SR
Masland
Massachusetts General Hospital, McLean Hospital, Belmont, MA 02478 USA.
James A
JA
Jenkins
Harvard Medical School, McLean Hospital, 115 Mill St., Mail Stop 312, Belmont, MA 02478 USA.
Brandon T
BT
Unruh
Borderline personality disorder; Dialectical behavior therapy; General psychiatric management; Mentalization-based treatment; Psychotherapy; Schema-focused therapy; Transference-focused psychotherapy