Skip to main content

Advertisement

SpringerLink
Log in

DBT and Schema Therapy for Borderline Personality Disorder: Mentalization as a Common Factor

  • Original Paper
  • Published:
Journal of Contemporary Psychotherapy Aims and scope Submit manuscript

Abstract

This paper adds to the existing body of literature by examining two different therapeutic approaches to the treatment of borderline personality disorder (BPD), namely: (1) dialectical behavior therapy (DBT), and (2) schema therapy. DBT is an evidence-based treatment for BPD while schema therapy is gaining ground as an effective therapy for BPD. Treatment approaches and etiological conceptualizations of each therapeutic modality are compared and contrasted. Theoretical underpinnings of each therapy are cognitive and behavioural but each therapy has developed its own techniques and rationale. Mentalization is discussed as an important mechanism of change in the successful treatment of BPD that is seen to underlie both DBT and schema therapy. To conclude DBT efficacy studies and schema therapy effectiveness studies are briefly reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Allen, J. G. (2008). Coping with trauma: Hope through understanding. Arlington: American Psychiatric Pub.

    Google Scholar 

  • American Psychiatric Association. (2001). Practice guidelines for the treatment of patients with borderline personality disorder: American Psychiatric Association Guidelines. American Journal of Psychiatry, 158, 1–58.

    Article  Google Scholar 

  • Bamelis, L. M., Evers, A. M. A. A., Spinhoven, P., & Arntz, A. (2014). Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders. American Journal of Psychiatry, 171, 305–322.

    Article  PubMed  Google Scholar 

  • Björgvinsson, T., & Hart, J. (2006). Cognitive behavioral therapy promotes mentalizing. In J. G. Allen & P. Fonagy (Eds.), Handbook of mentalization-based treatment (pp. 157–170). Sussex: Wiley.

    Chapter  Google Scholar 

  • Bricker, D., & Labin, M. (2012). Teaching mindfulness meditation in a schema therapy framework. In M. van Vreeswijk, J. Broersen, & M. Nadort (Eds.), The Wiley-Blackwell handbook of schema therapy: Theory, research and practice (pp. 259–270). Maklen, MA: Wiley.

    Chapter  Google Scholar 

  • Carter, G. L., Willcox, C. H., Lewin, T. J., Conrad, A. M., & Bendit, N. (2010). Hunter DBT project: Randomized controlled trial of dialectical behavior therapy in women with borderline personality disorder. Australian and New Zealand Journalof Psychiatry, 44, 162–173.

    Article  Google Scholar 

  • Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66, 7–18.

    Article  PubMed  CAS  Google Scholar 

  • Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2007). Evaluating three treatments for borderline personality disorder: A multiwave study. The American Journal of Psychiatry, 164, 922–928.

    Article  PubMed  Google Scholar 

  • Dimeff, L., & Linehan, M. (2001). Dialectical behaviour therapy in a nutshell. The California Psychologist, 34, 10–13.

    Google Scholar 

  • Edwards, D., & Arntz, A. (2012). Schema therapy in historical perspective. In M. van Vreeswijk, J. Broersen, & J. Nadort (Eds.), The Wiley-Blackwell handbook of schema therapy: Theory, research and practice (pp. 3–28). Maklen, MA: Wiley.

    Google Scholar 

  • Farrell, J. M., Shaw, I. A., & Webber, M. A. (2009). A schema-focused approach to group psychotherapy for outpatients with borderline personality disorder: a randomized controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 40, 317–328.

    Article  PubMed  Google Scholar 

  • Fonagy, P., & Bateman, A. W. (2007). Mentalizing and borderline personality disorder. Journal of Mental Health, 16, 83–101.

    Article  Google Scholar 

  • Giesen-Bloo, J., van Dyck, R., Spinhoven, P., van Tilburg, W., Dirksen, C., van Asselt, T., & Arntz, A. (2006). Outpatient psychotherapy for borderline personality disorder: Randomized trial of schema-focused therapy versus transference-focused psychotherapy. Archives of General Psychiatry, 63, 649–659.

    Article  PubMed  Google Scholar 

  • Goodman, G. (2013). Is mentalization a common process factor in transference-focused psychotherapy and dialectical behavior therapy sessions? Journal of Psychotherapy Integration, 23, 179–192.

    Article  Google Scholar 

  • Harned, M. S., Chapman, A. L., Dexter-Mazza, E. T., Murray, A., Comtois, K. A., & Linehan, M. M. (2008). Treating co-occuring axis I disorders in recurrently suicidal women with borderline personality disorder. Journal of Consulting and Clinical Psychology, 76, 1068–1075.

    Article  PubMed  Google Scholar 

  • Kellogg, S. H., & Young, J. E. (2006). Schema therapy for borderline personality disorder. Journal of Clinical Psychology, 62, 445–458.

    Article  PubMed  Google Scholar 

  • Kliem, S., Kroger, C., & Kosfelder, J. (2010). Dialectical behavior therapy for borderline personality disorder: A meta-analysis using mixed-effects modelling. Journal of Consulting and Clinical Psychology, 78, 936–951.

    Article  PubMed  Google Scholar 

  • Koons, C. R., Robins, C. J., Tweed, J. L., Lynch, T. R., Gonzalez, A. M., Morse, J. Q., & Bastian, L. A. (2001). Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behavior Therapy, 32, 371–390.

    Article  Google Scholar 

  • Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.

    Google Scholar 

  • Linehan, M. M. (2015). DBT skills training manual (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Linehan, M. M., Armstrong, H. E., Suarez, A., Allmon, D., & Heard, H. L. (1991). Cognitive behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48, 1060–1064.

    Article  PubMed  CAS  Google Scholar 

  • Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., & Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63, 757–766.

    Article  PubMed  Google Scholar 

  • Linehan, M., Dimeff, L., Reynolds, S. K., Comtois, K. A., Shaw-Welch, S., Heagerty, P., & Kivlahan, D. R. (2002). Dialectical behavior therapy versus comprehensive validation plus 12 step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug and Alcohol Dependence, 67, 13–26.

    Article  PubMed  Google Scholar 

  • Lobbestael, J., Arntz, A., & Sieswerda, S. (2005). Schema modes and childhood abuse in borderline and antisocial personality disorders. Journal of Behavior Therapy and Experimental Psychiatry, 36(3), 240–253.

    Article  PubMed  Google Scholar 

  • Lynch, T. R., Chapman, A. L., Rosenthal, M. Z., Kuo, J. R., & Linehan, M. M. (2006). Mechanisms of change in dialectical behavior therapy: Theoretical and empirical observations. Journal of Clinical Psychology, 62, 459–480.

    Article  PubMed  Google Scholar 

  • Masley, S. A., Gillanders, D. T., Simpson, S. G., & Taylor, M. A. (2012). A systematic review of the evidence base for schema therapy. Cognitive Behavior Therapy, 41, 185–202.

    Article  Google Scholar 

  • McMain, S. F., Links, P. S., Gnam, W. H., Guimond, T., Cardish, R. J., Korman, L., & Streiner, D. L. (2009). A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder. The American Journal of Psychiatry, 166, 1365–1374.

    Article  PubMed  Google Scholar 

  • Morrison, N. (2000). Schema-focused cognitive therapy for complex, long-standing problems: A single case study. Behavioral and Cognitive Psychotherapy, 23, 269–283.

    Article  Google Scholar 

  • Nordahl, H. M., & Nysaeter, T. E. (2005). Schema therapy for patients with borderline personality disorder: a single case series. Journal of Behavior Therapy and Experimental Psychiatry, 36, 254–264.

    Article  PubMed  Google Scholar 

  • Oldham, J. M. (2005). Guideline watch: Practice guideline for the treatment of patients with borderline personality disorder. Focus, 3(3), 396–400.

    Article  Google Scholar 

  • Palmer, R. L. (2002). Dialectical behavior therapy for borderline personality disorder. Advances in Psychiatric Treatment, 8, 10–16.

    Article  Google Scholar 

  • Perris, P., Fretwell, H., & Shaw, I. (2012). Therapist self‐care in the context of limited reparenting. In M. van Vreeswijk, J. Broersen, & M. Nadort (Eds.), The Wiley-Blackwell handbook of schema therapy: Theory, research, and practice (pp. 473–491). Maklen: Wiley.

    Chapter  Google Scholar 

  • Rizvi, S. L., & Ritschel, L. A. (2014). Mastering the art of chain analysis in dialectical behavior therapy. Cognitive and Behavioral Practice, 21(3), 335–349.

    Article  Google Scholar 

  • Rizvi, S. L., Steffel, L. M., & Carson-Wong, A. (2013). An overview of dialectical behavior therapy for professional psychologists. Professional Psychology: Research and Practice, 44, 73–80.

    Article  Google Scholar 

  • Robbins, C. J. (2002). Dialectical behavior therapy for borderline personality disorder. Psychiatric Annals, 32, 608–616.

    Article  Google Scholar 

  • Sempértegui, G. A., Karreman, A., Arntz, A., & Bekker, M. H. J. (2013). Schema therapy for borderline personality disorder: a comprehensive review of its empirical foundations, effectiveness and implementation possibilities. Clinical Psychology Review, 33, 426–447.

    Article  PubMed  Google Scholar 

  • Spinhoven, P., Geisen-Bloo, J., van Dyck, R., Kooiman, K., & Arntz, A. (2007). The therapeutic alliance in schema-focused therapy and transference-focused psychotherapy for borderline personality disorder. Journal of Consulting and Clinical Psychology, 75, 667–686.

    Article  Google Scholar 

  • Stanley, B., Brodsky, B., Nelson, J. D., & Dulit, R. (2007). Brief dialectical behavior therapy (DBT-B) for suicidal behavior and non-suicidal self injury. Archives of Suicide Research, 11, 337–341.

    Article  PubMed  Google Scholar 

  • van den Bosch, L. M. C., Koeter, M. W. J., Stijnen, T., Verheul, R., & van den Brink, W. (2005). Sustained efficacy of dialectical behavior therapy for borderline personality disorder. Behaviour Research and Therapy, 43, 1231–1241.

    Article  PubMed  Google Scholar 

  • van den Kieboom, P., & Jonker, D. (2012). Individual schema therapy. In M. van Vreeswijk, J. Broersen, & M. Nadort (Eds.), The Wiley-Blackwell handbook of schema therapy: Theory, research, and practice (pp. 311–322). Maklen: Wiley.

    Chapter  Google Scholar 

  • Verheul, R., van den Bosch, L. M. C., Koeter, M. W. J., de Ridder, M. A. J., Stijnen, T., & van den Brink, W. (2003). Dialectical behavior therapy for women with borderline personality disorder. British Journal of Psychiatry, 182, 135–140.

    Article  PubMed  Google Scholar 

  • Young, J. E., Klosko, J., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. New York: Guilford Press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Western University, London, ON, Canada

    Stephanie Montgomery-Graham

Authors
  1. Stephanie Montgomery-Graham
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stephanie Montgomery-Graham.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Montgomery-Graham, S. DBT and Schema Therapy for Borderline Personality Disorder: Mentalization as a Common Factor. J Contemp Psychother 46, 53–60 (2016). https://doi.org/10.1007/s10879-015-9309-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10879-015-9309-0

Keywords

Search

Navigation