How Conceptualization Of The Relations Between Depression And Bpd Informs Psychotherapy

In our view, understanding the causal relations between the patient's depression and his/her BPD characteristics has little relevance for how best to sequence psychotherapy, at least cognitive-behavioral therapies. From a behavioral perspective, the concept of discrete disorders, as in DSM-IV, is rarely the most helpful way to conceptualize a patient's problems. Instead, other principles should guide sequencing of therapy, such as first targeting problems that threaten the patient's life or the lives of others (e.g., self-injurious behavior), then problems that undermine treatment (e.g., serious therapy relationship problems), and finally problems that seriously undermine quality of life (e.g., inactivity, depressed mood).

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