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17b - Implementation Challenges in Real World Settings: Commentary on Cognitive Behavioral Approaches

from Part V - Treatment

Published online by Cambridge University Press:  24 February 2020

By
Andrea L. Gold  and
Shirley Yen
Edited by
Carl W. Lejuez  and
Kim L. Gratz
Carl W. Lejuez
Affiliation:
University of Kansas
Kim L. Gratz
Affiliation:
University of Toledo, Ohio
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Summary

This commenatry on Rosenthal, Wyatt, and McMahon’s review of cognitive and behavioral therapies (CBTs) for personality disorders (PDs) discusses implementation challenges to cognitive and behavioral approaches in real world settings. Multiple interventions show some empirical support for the treatment of PDs, including dialectical behavior therapy (DBT), schema-focused therapy (SFT), cognitive therapy for personality disorders, emotion regulation group therapy (ERGT), and systems training for emotional predictability and problem solving (STEPPS). Most of this work is restricted to borderline personality disorder (BPD) and DBT, whereas strong empirical support for other PDs is lacking. Here the authors discuss possible factors that may account for differential research support for the treatment of BPD relative to other PDs. For example, the BPD diagnosis includes suicidal and self-injurious behaviors among its criteria and is associated with DBT and its relevant training organizations and adaptations across multiple levels of care. Additionally, they provide examples in which interventions have been implemented ahead of the science. Finally, they discuss challenges to implementing CBTs for PDs in real world settings, such as diagnostic heterogeneity, comorbid presentations, and dual diagnosis, as well as the longstanding nature of problems associated with PDs.

Keywords

dialectical behavior therapycognitive behavioral therapytreatmentpersonality disordersborderline personality disorderimplementation
Type
Chapter
Information
The Cambridge Handbook of Personality Disorders , pp. 422 - 424
Publisher: Cambridge University Press
Print publication year: 2020

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