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Psychotherapy integration and borderline personality pathology: An examination of treatment outcomes [2018]

The present study sought to investigate the impact of psychotherapy integration, incorporating some cognitive–behavioral (CB) techniques with psychodynamic–interpersonal (PI) techniques, with the moderating impact of borderline personality pathology on short-term psychodynamic psychotherapy treatment outcomes in a sample of 75 outpatients. PI and CB techniques were assessed using independent videotape ratings of therapy sessions and aspects of the alliance were determined using patient-rated scores. Axis II borderline personality pathology was measured using the Borderline Pathology Index (BPI). Treatment outcomes were measured using patients’ estimates of their broadband functioning (PEI) and change in global symptom index of the brief symptom inventory (BSI-GSI-RCI). Findings of preliminary analyses were nonsignificant; the direct relationship between patient pretreatment borderline pathology with the flexible integration of CB and PI techniques was not significant. In addition, PI and CB techniques derived from the CPPS each demonstrated nonsignificant relationships with the BPI, respectively. Multilevel model analyses indicated that when controlling for therapist effects, pretreatment borderline pathology did not moderate symptom change (improvement or deterioration) or patient estimates of their broadband functioning. Post hoc analyses demonstrated some significant findings, indicating that therapist, but not patient, confident collaboration scores were negatively related to borderline personality pathology, although this did not significantly impact treatment outcomes. Taken together, findings from the present study suggest that the interaction between borderline personality pathology and the integration of some cognitive-behavioral techniques within psychodynamic psychotherapy do not affect statistically significant change in treatment outcome. Implications are discussed for clinical research and practice.

Goldman, Rachel E. Hilsenroth, Mark J. Gold, Jerold R. Cersosimo, Bianca H. Levy, Saryn R. Owen, Jesse J.

Journal of Psychotherapy Integration, 2018

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