Olga Olga KaragiorgouKaragiorgouPsychologist AssistantPsychologist AssistantPsychologist AssistantPsychologist AssistantOlga.Karagiorgou@ggc.scot.nhs.ukOlga.Karagiorgou@ggc.scot.nhs.uk

Two different prominent models for interveningTwo different prominent models for intervening with self-harm and/or emerging Borderline Personality Disorder (BPD): Dialectical Behaviour Therapy (DBT) and Mentalisation Based TherapyTherapy (DBT) and Mentalisation Based Therapy (MBT):Developed for chronic suicidal adults.

d d f h f d lAdapted for the treatment of adolescents, as DBT- A and MBT-A.

• Implementation of DBT-A and evaluation studyImplementation of DBT A and evaluation study by NHS GG&C and partners.

• Examine in depth the advantages/disadvantages, outcomes and methodologies used in DBT A andoutcomes and methodologies used in DBT-A and MBT-A studies.

modified form of Cognitive Behaviourmodified form of Cognitive Behaviour Therapyhelps people change harmful behaviourshelps people change harmful behaviours (change)And focuses on accepting them as they are atAnd focuses on accepting them as they are at that moment (acceptance)Posits that BPD results from the interaction ofPosits that BPD results from the interaction of biological vulnerability with invalidating environmentsenvironments. Overall goal: create a life worth living.

Psychodynamic treatment with roots inPsychodynamic treatment with roots in attachment and developmental theories.Posits that people with BPD have a decreasedPosits that people with BPD have a decreased capacity for mentalisation.Mentalisation is the capacity to understandMentalisation is the capacity to understand our own and others’ behaviours and thoughts in attachment contextsin attachment contexts.Hypermentalising?? *Its primary focus is to restore mentalisationIts primary focus is to restore mentalisation.

Adolescents with self-harming behaviour or/and BPD traits in inpatient/outpatient/correctional facilities.B h i i d bBoth interventions are reported to be more effective than TAU (Treatment As Usual). Only one RCT for each intervention:Only one RCT for each intervention:

DBT-A 26% dropout rate, MBT-A 50% dropout rate. DBT A foc ses on self harm s icidal beha io rDBT-A: focuses on self-harm, suicidal behaviour and ideation, emotional regulation and general functioningfunctioning.MBT-A: focuses on mentalising and attachment.

Small sample size, gender issues, methodologySmall sample size, gender issues, methodology issues, outcome measures, definition of self-harmNo conclusions can be drawn only 2 RCTsNo conclusions can be drawn - only 2 RCTs. DBT more likely to reinforce the capacity of skilful behaviours in order to help the patient f d l h blfind more positive solutions to their problems.MBT focused on reflective functioning and mentalising in order to render the individualsmentalising, in order to render the individuals capable of finding the solutions themselves. DBT has some elements of mentalising within it. Interesting to see if DBT can contribute to theInteresting to see if DBT can contribute to the enhancement of mentalisation.

Linehan M M (1993) Cognitive-behaviouralLinehan, M. M. (1993). Cognitive-behavioural treatment of borderline personality disorder. New York NY: Guilford PressNew York, NY: Guilford Press. Rathus & Miller (2007). …

Thank you!Thank you!Thank you!Thank you!

Olga KaragiorgouOlga KaragiorgouOlga.Karagiorgou@ggc.scot.nhs.uk