{"title":"Working Alliance Instability in the Inpatient Treatment of Borderline Personality Disorder","authors":"Leonhard Kratzer, Josefine Moultrie, Günter Schiepek","doi":"10.1007/s10879-024-09630-0","DOIUrl":null,"url":null,"abstract":"<p>Borderline personality disorder (BPD) is characterized by a pathognomonic instability of interpersonal relationships. Therefore, a good working alliance in the treatment of BPD may go beyond qualitative aspects like agreement on goals and mutual trust, and in particular depend on a balancing of instability. Yet, little is known about working alliance dynamics in the treatment of BPD. Using daily ratings of the Therapy Process Questionnaire, we retrospectively investigated assessments of the stability of the therapeutic alliance during inpatient treatment in 51 patients with BPD and 66 patients with major depressive disorder. Regression analyses were used to investigate whether working alliance was more unstable in patients with BPD and how it was associated to outcome. The working alliance was found to be significantly more unstable in patients with BPD. Yet, a high dynamic complexity of the working alliance was found to be linked to better outcomes in BPD, possibly hinting at the importance of rupture and repair.</p>","PeriodicalId":46994,"journal":{"name":"JOURNAL OF CONTEMPORARY PSYCHOTHERAPY","volume":"28 1","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JOURNAL OF CONTEMPORARY PSYCHOTHERAPY","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s10879-024-09630-0","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Borderline personality disorder (BPD) is characterized by a pathognomonic instability of interpersonal relationships. Therefore, a good working alliance in the treatment of BPD may go beyond qualitative aspects like agreement on goals and mutual trust, and in particular depend on a balancing of instability. Yet, little is known about working alliance dynamics in the treatment of BPD. Using daily ratings of the Therapy Process Questionnaire, we retrospectively investigated assessments of the stability of the therapeutic alliance during inpatient treatment in 51 patients with BPD and 66 patients with major depressive disorder. Regression analyses were used to investigate whether working alliance was more unstable in patients with BPD and how it was associated to outcome. The working alliance was found to be significantly more unstable in patients with BPD. Yet, a high dynamic complexity of the working alliance was found to be linked to better outcomes in BPD, possibly hinting at the importance of rupture and repair.
期刊介绍：
Journal of Contemporary Psychotherapy provides an international forum to critique the complexities and controversies facing psychotherapists. The journal publishes original peer-reviewed articles that critically analyze theory, research, or clinical practice. Empirical studies, panel discussions, essays, case studies, brief reports, and theoretical articles are published. Psychotherapists and clinical researchers will find this journal an important vehicle to review the problems of treating a variety of patients.
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