THE DIALECTICAL BEHAVIORAL-THERAPY ACCORD ING TO LINEHAN,M. - A NEW CONCEPT OF TREATMENT FOR BORDERLINE PERSONALITY-DISORDERS

M. Linehan developed ''dialectical behavioral therapy'' specifically t o treat chronically suicidal borderline patients. It rests on a biosoc ial model that assumes a disorder in the regulation of emotions and in tolerance of stress. The numerous dysfunctional patterns of behavior such as self-destructive behavior, inability to govern impulses or sev ere dissociative phenomena are regarded as attempts at problem-solving . This concept of therapy focuses on the continuing balance between th e necessity of accepting maladaptive behavior patterns in both an intr apsychic and an interactional context while still working to change th em. A comprehensive manual outlines the clearly structured therapy and integrates a wide choice of therapeutic strategies. Parallel to devel opment of the therapy itself, a method also was developed for testing therapist adherence to the manual's guidelines, thus providing a basis for empirical evaluation. An initial controlled, randomized study dem onstrated the significant superiority of this method to methods of uns pecific psychotherapy at various levels. In the current endeavor to de velop disorder-specific approaches to the treatment of personality dis orders, ''dialectical behavioral therapy'' is a noteworthy model.