Cambanis Elizabeth Va
a Psychology Department , Fort Napier Hospital , PO Box 370 , Pietermaritzburg , 3200 , South Africa.
J Child Adolesc Ment Health. 2012 Jul;24(1):99-109. doi: 10.2989/17280583.2011.639075.
Clients with borderline personality disorder are viewed as difficult to work with. They also have high drop-out rates and unpredictable treatment outcomes. The characteristics of patients with borderline personality disorder often have a negative effect on the therapeutic process and on clinicians themselves. Challenges are likely magnified for trainee psychologists, given their lack of experience in implementing treatment plans and their inadequate understanding of underlying dynamics. However, to date, no studies have focused on the particular challenges experienced by trainee psychologists. This article attempts to address the gap in literature by exploring the difficulties experienced by a trainee psychologist in treating a patient with borderline personality disorder. A case study is used to highlight the challenges experienced by a novice psychologist in using specific therapeutic modalities recommended in the treatment of borderline personality disorder (BPD), namely dialectical behaviour therapy (DBT) and mentalisation based therapy (MBT). The aim of the study was to help better identify, understand and normalise the countertransference experiences and other difficulties experienced by trainee psychologists in treating clients with BPD. The article highlights observations regarding the context of the supervisory process, the importance of personal psychotherapy, the potential for harm of pejorative views, and the complications arising from a mismatch between the treatment modality and the treatment context.
边缘型人格障碍患者被认为难以合作。他们的脱落率也很高，治疗结果难以预测。边缘型人格障碍患者的特征往往会对治疗过程以及临床医生自身产生负面影响。对于实习心理学家来说，挑战可能会更大，因为他们在实施治疗计划方面缺乏经验，对潜在的动力机制理解不足。然而，迄今为止，尚无研究关注实习心理学家所面临的特殊挑战。本文试图通过探讨一名实习心理学家在治疗一名边缘型人格障碍患者时所遇到的困难来填补文献中的空白。一项案例研究用于突出一名新手心理学家在使用边缘型人格障碍（BPD）治疗中推荐的特定治疗方式，即辩证行为疗法（DBT）和基于心理化的疗法（MBT）时所面临的挑战。该研究的目的是帮助更好地识别、理解实习心理学家在治疗BPD患者时所经历的反移情体验和其他困难，并使其正常化。本文强调了关于督导过程背景、个人心理治疗的重要性、贬损性观点的潜在危害以及治疗方式与治疗背景不匹配所产生的并发症的观察结果。
