Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University, New York.
Special Lecturer in Psychiatry, Department of Psychiatry, Columbia University, New York.
Psychodyn Psychiatry. 2021 Summer;49(2):296-321. doi: 10.1521/pdps.2021.49.2.296.
Good psychiatric management for borderline personality disorder (GPM) and transference-focused psychotherapy (TFP) are evidence-supported treatments that may be used in a complementary, flexible manner to provide a spectrum of psychodynamically informed care. In this article, we provide overviews of TFP and GPM, describing GPM's eclectic approach that includes psychodynamically informed supportive psychotherapy, case management, and medication management, informed by a model of hypersensitivity to rejection, comparing it with TFP's focus on identity integration and modification of standard psychodynamic techniques for use in treating patients with borderline personality disorder. We outline convergences and divergences between TFP and GPM in assessment, establishment of treatment goals and a treatment agreement, family involvement, and moment-to-moment psychotherapeutic interventions. The options for integration of TFP and GPM theoretical principles, as well as for models of treatment sequencing, are explored. Clinical vignettes are provided that illustrate sequential uses of GPM and TFP as part of psychodynamically informed long-term clinical management.
边缘型人格障碍的良好精神科管理（GPM）和转移焦点心理治疗（TFP）是循证治疗方法，可采用互补、灵活的方式提供一系列心理动力学知情护理。在本文中，我们提供了 TFP 和 GPM 的概述，描述了 GPM 的折衷方法，其中包括心理动力学知情支持性心理治疗、个案管理和药物管理，这些方法是基于对拒绝的高度敏感模型，并将其与 TFP 对身份整合的关注以及对标准心理动力学技术的修改进行比较，以用于治疗边缘型人格障碍患者。我们概述了 TFP 和 GPM 在评估、治疗目标和治疗协议的制定、家庭参与以及即时心理治疗干预方面的异同。探讨了整合 TFP 和 GPM 理论原则以及治疗顺序模型的选择。提供了临床案例，说明了 GPM 和 TFP 作为心理动力学长期临床管理的一部分的顺序使用。
