Over the past decades mental health services around the world are faced with a high number of patients with borderline personality disorder (BPD) which has resulted in a particular emphasis on research for specialist treatments for this class of disorders. At least 5 psychotherapeutic models are based on evidence from clinical trials that support their effectiveness. In this review we present the latest research evidence as well as a summary of the basic characteristics of Transference-Focused Psychotherapy and Mentalization Based Treatment, which are not yet widely used in Greece. The two modalities originate from the psychoanalytic tradition and they have various points of convergence and divergence with regards to their structure (individual, group, combined) the role of the therapist and their use of basic theoretical concepts (eg. attachment, aggression). Their descriptive presentation in the form of a treatment manual and the standardisation of their training model, makes them accessible for training therapists and allows their introduction in psychiatric training programmes. We present a clinical case as an example of the application of the two approaches, along with the clinical and research paradigm originating from DeanCross Personality Disorder Service in London and the Centre for Understanding Personality Disorder, in order to compare the basic theoretical and technical characteristics of the two therapeutic modalities in view of their unique application within one outpatient service in the community. DeanCross provides a mixed MBT model (group, individual) with psychiatric input, which has been updated by the introduction of TFP in individual and group formats. Our review aligns with the international current that does not regard the two models in competition with each other; instead, we present a successful paradigm of their compatibility and mutual enrichment. The successful introduction of these therapies in the British public healthcare system, which is similar in its characteristics to the Greek national health system, is an encouraging prognostic factor when it comes to the applicability of these models in the Greek paradigm. It is a necessary prerequisite that clinical and theoretical knowledge of services that care for populations with a high prevalence of BPD is updated, and the current review makes a contribution in this direction. 

KEYWORDS: Transference, mentalization, borderline, narcissistic, evidence based, psychotherapy.

Orestis Kanter Bax, Georgios Nerantzis

 

Full Article in pdf (Greek)