Effectiveness of time-limited cognitive analytic therapy of borderline personality disorder: factors associated with outcome

Abstract

Most patients with borderline personality disorder receive no formal treatment for their personality disorder and psychotherapy is widely believed to be necessarily intensive, of long duration and of uncertain effect. This study seeks to demonstrate the scope and limits of time-limited outpatient cognitive analytic psychotherapy. Cases were identified by standard diagnostic procedures. Most were referred from psychiatrists and were typical of inner city patient populations. At an assessment 6 months after therapy the 27 patients completing therapy were divided into 'improved' and 'unimproved' groups. The patients classified as improved no longer met diagnostic criteria for borderline personality disorder. The two-thirds still traceable were re-tested at 18 months. These groups were compared in terms of a number of pre-therapy measures and features. Poorer outcome was associated with greater severity of borderline features, a history of self-cutting, alcohol abuse and unemployment.