Techniques for reducing therapy-interfering behavior in patients with borderline personality disorder. Similarities in four diverse treatment paradigms.

Successful management of patient behaviors that interfere with the process of psychotherapy is essential to treating patients with borderline personality disorder. Provocative patient behaviors that induce a strong negative reaction from the therapist must be attenuated. Strategies for doing so used in four different treatment paradigms--Kernberg's expressive psychotherapy, Linehan's dialectical behavior therapy, Benjamin's interpersonal psychotherapy, and Allen's unified psychotherapy--are examined, and striking similarities are seen. A theoretical model is proposed to explain why the techniques may be effective.