Enhancing the Social Network: Multimodal Treatment for Comorbid Borderline Personality Disorder and Alcohol Use Disorder.

IF 2.3 Q2 PSYCHOLOGY, CLINICAL
Edward H Patzelt, Stephen Conway, Sam A Mermin, Julia Jurist, Lois W Choi-Kain
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引用次数: 0

Abstract

More than half of all people with borderline personality disorder will develop alcohol use disorder in their lifetime. These disorders mutually reinforce each other, with a higher risk for treatment failure and poor outcomes, including suicide, yet no widely available treatments have been found to be effective for both diagnoses concurrently, leaving patients and clinicians alike stranded between two clinical domains that rarely overlap despite shared features. In the absence of alternatives, good psychiatric management (GPM) capitalizes on standard-of-care interventions using generic clinical tools that do not require specialization. In an effort to broaden and stabilize the social networks of connections for patients with interpersonal hypersensitivity, GPM relies on a multimodal approach that combines the indicated pharmacological and psychosocial interventions for the treatment of alcohol use disorder with a common-factors approach for borderline personality disorder. This multimodal approach emphasizes psychoeducation, social rehabilitation, management of suicidality, and active management of these frequently comorbid conditions. In this article, the authors describe GPM's strategy of stabilizing and broadening the patient's social network to target the core interpersonal and stress hypersensitivity. To do this, clinicians can use interventions for significant others combined with empirically supported and widely available mutual-help groups, such as Alcoholics Anonymous, that structure and regulate relational instabilities with community norms, standards, roles, and procedures. GPM also promotes family interventions for both conditions to reduce conflict and increase support within existing relationships, thereby strengthening patients' capacity to work on their sobriety and borderline personality disorder by mitigating aloneness and its effects.

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来源期刊
AMERICAN JOURNAL OF PSYCHOTHERAPY
AMERICAN JOURNAL OF PSYCHOTHERAPY PSYCHOLOGY, CLINICAL-
CiteScore
2.90
自引率
4.00%
发文量
39
期刊介绍: Founded in 1939, the American Journal of Psychotherapy (AJP) has long been a leader in the publication of eclectic articles for all psychotherapists. Transtheoretic in reach (offering information for psychotherapists across all theoretical foundations), the goal of AJP is to present an overview of the psychotherapies, subsuming a host of schools, techniques, and psychological modalities within the larger domain of clinical practice under broad themes including dynamic, behavioral, spiritual, and experiential.
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