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This book offers clear, practical, and simple recommendations for
treating patients with personality disorders. The goals of the book
are twofold: 1) to describe the essential elements of
Transference-Focused Psychotherapy (TFP), an evidence-based
treatment for Borderline Personality Disorder, and 2) to describe
how core principles and techniques of TFP can be used in a variety
of settings to improve clinical management of patients with a broad
spectrum of personality pathology, even when patients are not
engaged in individual psychotherapy. A short introduction outlines
in concise language the core elements of TFP and its origins in
object relations theory. The book then takes the clinician through
the process of: 1) comprehensive diagnosis, 2) negotiation of the
treatment frame, and 3) the overarching strategies, techniques, and
tactics used in the individual treatment, including helpful,
accessible clinical vignettes. Subsequent chapters build on the
literature of TFP in individual psychotherapy, broadening its
applications to include crisis management, family engagement,
inpatient psychiatry, pharmacotherapy, medical settings, psychiatry
residency training. Fundamentals of Transference-Focused
Psychotherapy is a valuable resource for psychiatrists,
psychologists, and all other medical professionals treating
patients suffering from Borderline Personality Disorder, and other
severe personality disorder presentations.
After 30 years of declining practice among psychiatrists,
psychotherapy is being increasingly recognized as a valuable tool
in psychiatric care. While this renewed appreciation offers hope
for the future, a serious challenge remains: There are alarmingly
few psychiatrists equipped as psychotherapy supervisors to help
train the next generation of psychiatrists. Encouraging
psychiatrists to consider stepping into this important role is what
makes Supervising Individual Psychotherapy such a timely and
indispensable resource. With a multipronged approach that combines
the theoretical and the practical, supported by illustrative
clinical vignettes, this guide focuses on four key areas: • The
process of supervisor development, including helpful tools for
building supervisory skills and fostering self-growth, practical
methods for establishing and maintaining a healthy supervisory
relationship, and a collection of vignettes to highlight the
supervisee's perspective. Also addressed are common ethical
questions that arise in the supervisory process. • Specific
techniques used in supervision, including how to establish and
monitor goals for supervision, provide supervision via
internet-mediated videoconferencing, and thoughtfully plan for the
termination of supervision. • Psychotherapy supervision for
specific populations and within various care settings, including
supervision of supportive therapy in hospital units and emergency
departments, cognitive-behavioral therapy, substance use disorder
treatment, and combination treatment of psychotherapy and
pharmacotherapy. Also discussed are the possible effects of the
supervisee's and the supervisor's race, gender identity, and sexual
preferenceorientation on the supervisory process. • Challenges
that may arise in supervision, including an examination of the
effects of marriage, divorce, illness, and death on the supervisory
dyad; the legal aspects of supervision (e.g., confidentiality,
medicolegal liability); and the risks of burnout in both the
supervisor and the supervisee. With a richness of detail organized
in an accessible and easy-to-reference format, this book clearly
covers the skills, capabilities, and qualities needed to provide
effective psychotherapy supervision—and is tailor-made for early-
and mid-career supervisors who are looking to develop and refine
their skills.
Treating borderline patients is one of the most challenging areas
in psychotherapy because of the patient's extreme emotional
expressions, the strain it places on the therapist, and the danger
of the patient acting out and harming himself or the therapeutic
relationship. Many clinicians consider this patient population
difficult, if not impossible, to treat. However, in recent years
dedicated experts have focused their clinical and research efforts
on the borderline patient and have produced treatments that
increase our success in working with borderline patients.
Transference-Focused Therapy (TFP) is psychodynamic treatment
designed especially for borderline patients. This book provides a
concise and comprehensive introduction to TFP that will be useful
both to experienced clinicians and also to students of
psychotherapy. TFP has its roots in object relations and it
emphasizes that the transference is the key to understanding and
producing change. The patient's internal world of object
representations unfolds and is lived in the transference with the
therapist. The therapist listens for and makes use of the
relationship that is revealed through words, silence, or, as often
occurs in the case of individuals with some borderline personality
disorder, acting out in subtle or not-so-subtle ways. This primer
offers clinicians a way to understand and then use the transference
and countertransference for change in the patient.
Transference-Focused Psychotherapy for Borderline Personality
Disorder: A Clinical Guide presents a model of borderline
personality disorder (BPD) and its treatment that is based on
contemporary psychoanalytic object relations theory as developed by
the leading thinker in the field, Otto Kernberg, M.D., who is also
one of the authors of this insightful manual. The model is
supported and enhanced by material on current phenomenological and
neurobiological research and is grounded in real-world cases that
deftly illustrate principles of intervention in ways that mental
health professionals can use with their patients. The book first
provides clinicians with a model of borderline pathology that is
essential for expert assessment and treatment planning and then
addresses the empirical underpinnings and specific therapeutic
strategies of transference-focused psychotherapy (TFP). * From the
chapter on clinical assessment, the clinician learns how to select
the type of treatment on the basis of the level of personality
organization, the symptoms the patient experiences, and the areas
of compromised functioning. In order to decide on the type of
treatment, the clinician must examine the patient's subjective
experience (such as symptoms of anxiety or depression), observable
behaviors (such as investments in relationships and deficits in
functioning), and psychological structures (such as identity,
defenses, and reality testing). * Next, the clinician learns to
establish the conditions of treatment through negotiating a verbal
treatment contract or understanding with the patient. The contract
defines the responsibilities of each of the participants and
defines what the reality of the therapeutic relationship is. *
Techniques of treatment interventions and tactics to address
particularly difficult clinical challenges are addressed next,
equipping the therapist to employ the four primary techniques of
TFP (interpretation, transference analysis, technical neutrality,
and use of countertransference) and setting the stage for and
guiding the proper use of those techniques within the individual
session.* What to expect in the course of long-term treatment to
ameliorate symptoms and to effect personality change is covered,
with sections on the early, middle, and late phases of treatment.
This material prepares the clinician to deal with predictable
phases, such as tests of the frame, impulse containment, movement
toward integration, episodes of regression, and termination.*
Finally, the text is accompanied by supremely instructive online
videos that demonstrate a variety of clinical situations, helping
the clinician with assessment and modeling critical therapeutic
strategies. The book recognizes that each BPD patient presents a
unique treatment challenge. Grounded in the latest research and
rich with clinical insight, Transference-Focused Psychotherapy for
Borderline Personality Disorder: A Clinical Guide will prove
indispensable to mental health professionals seeking to provide
thoughtful, effective care to these patients.
Filling a crucial gap in the clinical literature, this book
provides a contemporary view of pathological narcissism and
presents an innovative treatment approach. The preeminent authors
explore the special challenges of treating patients--with
narcissistic traits or narcissistic personality disorder--who
retreat from reality into narcissistic grandiosity, thereby
compromising their lives and relationships. Assessment procedures
and therapeutic strategies have been adapted from
transference-focused psychotherapy (TFP), a manualized,
evidence-based treatment for borderline personality disorder. Rich
case material illustrates how TFP-N enables the clinician to engage
patients more deeply in therapy and help them overcome relationship
and behavioral problems at different levels of severity. The volume
integrates psychodynamic theory and research with findings from
social cognition, attachment, and neurobiology.
Deftly combining contemporary theory with clinical practice,
Psychodynamic Therapy for Personality Pathology: Treating Self and
Interpersonal Functioning is an invaluable resource for any
clinician seeking a coherent model of personality functioning and
pathology, classification, assessment, and treatment. This
insightful guide introduces Transference-Focused
Psychotherapy-Extended (TFP-E), a specialized but accessible
approach for any clinician interested in the skillful treatment of
personality disorders. Compatible with the DSM-5 Section III
Alternative Model for Personality Disorders-and elaborating on that
approach, this volume offers clinicians at all levels of experience
an accessible framework to guide evaluation and treatment of
personality disorders in a broad variety of clinical and research
settings. In this book, readers will find: * A coherent model of
personality functioning and disorders based in psychodynamic object
relations theory* A clinically near approach to the classification
of personality disorders, coupled with a comprehensive approach to
assessment* An integrated treatment model based on general clinical
principles that apply across the spectrum of personality disorders*
An understanding of specific modifications of technique that tailor
intervention to the individual patient's personality pathology*
Descriptions of specific psychodynamic techniques that can be
exported to shorter-term treatments and acute clinical settings
Patient assessment and basic psychodynamic techniques are described
in up-to-date, jargon-free terms and richly supported by numerous
clinical vignettes, as well as online videos demonstrating
interventions. At the end of each chapter, readers will find a
summary of key clinical concepts, making this book both a quick
reference tool as well as a springboard for continued learning.
Clinicians looking for an innovative, trustworthy guide to
understanding and treating personality pathology that combines
contemporary theory with clinical practice need look no further
than Psychodynamic Therapy for Personality Pathology: Treating Self
and Interpersonal Functioning.
This book offers clear, practical, and simple recommendations for
treating patients with personality disorders. The goals of the book
are twofold: 1) to describe the essential elements of
Transference-Focused Psychotherapy (TFP), an evidence-based
treatment for Borderline Personality Disorder, and 2) to describe
how core principles and techniques of TFP can be used in a variety
of settings to improve clinical management of patients with a broad
spectrum of personality pathology, even when patients are not
engaged in individual psychotherapy. A short introduction outlines
in concise language the core elements of TFP and its origins in
object relations theory. The book then takes the clinician through
the process of: 1) comprehensive diagnosis, 2) negotiation of the
treatment frame, and 3) the overarching strategies, techniques, and
tactics used in the individual treatment, including helpful,
accessible clinical vignettes. Subsequent chapters build on the
literature of TFP in individual psychotherapy, broadening its
applications to include crisis management, family engagement,
inpatient psychiatry, pharmacotherapy, medical settings, psychiatry
residency training. Fundamentals of Transference-Focused
Psychotherapy is a valuable resource for psychiatrists,
psychologists, and all other medical professionals treating
patients suffering from Borderline Personality Disorder, and other
severe personality disorder presentations.
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