Background: There is a dearth of studies evaluating treatment efcacy for adolescents diagnosed with borderline
personality disorder. The few available randomized controlled trials that have been conducted show modest results
and treatments appear to have equivalent efects. The current paper draws on (a) the lessons learnt from the last
50 years of psychotherapy research in general and (b) recent advances in mentalization-based understanding of why
treatment works, which together point to the importance of following a socioecological approach in the treatment
of personality problems in adolescence – a developmental period that insists on a treatment approach that goes
beyond the therapist-client dyad.
Case presentation: Here, we describe such an approach, and ofer a clinical case example with a young 16-year old
girl diagnosed with borderline personality disorder, to illustrate what a shift toward a more socioecological approach
would 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 with
borderline personality disorder beyond dyadic therapist-client work.
Keywords: Personality disorders, Adolescent, BPD, Treatment, Socioecological treatment, Epistemic trust,
Mentalization-based treatment, Psychotherapy research