TY - JOUR

T1 - Improving treatment outcomes for adolescents with borderline personality disorder through a socioecological approach

AU - Bo, Sune

AU - Sharp, Carla

AU - Kongerslev, Mickey T.

AU - Luyten, Patrick

AU - Fonagy, Peter

PY - 2022

Y1 - 2022

N2 - Background: There is a dearth of studies evaluating treatment efcacy for adolescents diagnosed with borderlinepersonality disorder. The few available randomized controlled trials that have been conducted show modest resultsand treatments appear to have equivalent efects. The current paper draws on (a) the lessons learnt from the last50 years of psychotherapy research in general and (b) recent advances in mentalization-based understanding of whytreatment works, which together point to the importance of following a socioecological approach in the treatmentof personality problems in adolescence – a developmental period that insists on a treatment approach that goesbeyond the therapist-client dyad.Case presentation: Here, we describe such an approach, and ofer a clinical case example with a young 16-year oldgirl diagnosed with borderline personality disorder, to illustrate what a shift toward a more socioecological approachwould entail.Conclusions: The clinical impact of the socioecological approach and the potential benefts as illustrated in the current case illustration, ofers a framework that justifes and allows for the expansion of service delivery for youth withborderline personality disorder beyond dyadic therapist-client work.Keywords: Personality disorders, Adolescent, BPD, Treatment, Socioecological treatment, Epistemic trust,Mentalization-based treatment, Psychotherapy research

AB - Background: There is a dearth of studies evaluating treatment efcacy for adolescents diagnosed with borderlinepersonality disorder. The few available randomized controlled trials that have been conducted show modest resultsand treatments appear to have equivalent efects. The current paper draws on (a) the lessons learnt from the last50 years of psychotherapy research in general and (b) recent advances in mentalization-based understanding of whytreatment works, which together point to the importance of following a socioecological approach in the treatmentof personality problems in adolescence – a developmental period that insists on a treatment approach that goesbeyond the therapist-client dyad.Case presentation: Here, we describe such an approach, and ofer a clinical case example with a young 16-year oldgirl diagnosed with borderline personality disorder, to illustrate what a shift toward a more socioecological approachwould entail.Conclusions: The clinical impact of the socioecological approach and the potential benefts as illustrated in the current case illustration, ofers a framework that justifes and allows for the expansion of service delivery for youth withborderline personality disorder beyond dyadic therapist-client work.Keywords: Personality disorders, Adolescent, BPD, Treatment, Socioecological treatment, Epistemic trust,Mentalization-based treatment, Psychotherapy research

KW - Faculty of Social Sciences

KW - personality disorder

KW - adolescent

KW - BPD

KW - socioecological treatment

KW - epistemic trust

KW - mentalization-based treatment

KW - psychotherapy research

U2 - 10.1186/s40479-022-00187-9

DO - 10.1186/s40479-022-00187-9

M3 - Journal article

C2 - 35701834

VL - 9

JO - Borderline Personality Disorder and Emotion Dysregulation

JF - Borderline Personality Disorder and Emotion Dysregulation

SN - 2051-6673

IS - 1

ER -