Uncategorized

Richard G. Hersh, Chiara De Panfilis

This book focuses on the practical utility of key precepts of Transference-Focused Psychotherapy (TFP) in contemporary psychiatry. This volume actively addresses the pressing public health crisis related to high numbers of patients with personality disorder pathology, often with significantly compromised functioning associated with marked social burdens related to health costs and lost productivity.

TFP is one of the empirically validated treatments for patients with borderline personality disorder (BPD). Building on this evidence base, the contributors to this volume describe their work in multiple clinical situations utilizing these principles with varying patient populations in different treatment settings. These settings include: the adult and adolescent day hospital, short term and extended inpatient hospitalizations, group therapy, and a range of outpatient services.  Each chapter follows a consistent format to cover patient population, nature of treatment setting, overview of financial support, training of clinicians, treatment targets, elements of TFP employed, measurement of effectiveness, case study examples, and future research goals. Contributors from different backgrounds describe active use of TFP principles in their work, with adjustments from standard TFP protocol made accordingly.

Implementing Transference-Focused Psychotherapy Principles builds on the growing literature about TFP by expanding the focus beyond the extended individual psychotherapy format. The text will resonate with psychiatrists, psychologists, social workers, and mental health counselors, among others. Clinicians involved in public health systems will find the material outlined of particular value in our evolving world of mental health services.

Implementing Transference-Focused psychotherapy principles. (2024). https://doi.org/10.1007/978-3-031-68062-5

Kevin B. Meehan, PhD, Nicole M. Cain, PhD, Michael J. Roche, PhD, Eric A. Fertuck, PhD, Julia F. Sowislo, PhD, and John F. Clarkin, PhD

Transference-focused psychotherapy (TFP) is an empirically supported treatment for borderline personality disorder (BPD) that improves functioning via targeting representations of self affectively relating to others, particularly as evoked in the therapeutic relationship. If change in TFP operates as theorized, then shifts in patterns of “self affectively relating to others” should be observed in the transference prior to shifts in daily relationships. Using ecological momentary assessment (EMA), a patient with BPD rated daily interpersonal events for 2-week periods during 18 months of TFP; at 9 and 18 months these ratings included interactions with the therapist. Results suggest that positive perceptions of her therapist that ran counter to her negatively biased perception in other relationships preceded changes in her perceptions of others. EMA shifts corresponded to improvements in self-reported symptoms, interview- based personality functioning, and therapist assessments. Implications for assimilation of a trusting experience with the therapist as a mechanism of change in TFP are discussed.

Meehan, K. B., Cain, N. M., Roche, M. J., Fertuck, E. A., Sowislo, J. F., & Clarkin, J. F. (2023). Evaluating Change in Transference, Interpersonal Functioning, and Trust Processes in the Treatment of Borderline Personality Disorder: A Single-Case Study Using Ecological Momentary Assessment. Journal of Personality Disorders, 37(5), 490–507. https://doi.org/10.1521/pedi.2023.37.5.490

Authors: Eric A. Fertuck, PhD, Emanuele Preti, PhD, and John F. Clarkin, PhD

Individuals with borderline personality disorder (BPD) struggle to identify whom they can safely trust, and this struggle contributes to profound
emotional turmoil in their close relationships. Transference-focused psychotherapy (TFP) is an application of object relations theory (ORT) that posits that polarized mental representations of self and other define the personality organization of BPD. TFP aims to utilize a clear treatment frame coupled with an analysis of the therapeutic relationship (i.e., the transference) to help individuals with BPD integrate their polarized mental representations. Improvement in the capacity to trust others is inherent in the mechanisms of change in TFP. In this article, a social cognitive model of trust processing provides a new lens through which we formulate how TFP may enhance trust processing in BPD. Recent evidence from randomized clinical trials supports the argument that TFP may intervene with BPD in a way that is concordant with uniquely improved trust processing

Fertuck, E. A., Preti, E., & Clarkin, J. F. (2023). Transference-Focused Psychotherapy and Trust Processing in BPD: Exploring Possible Mechanisms of Change. Journal of Personality Disorders, 37(5), 620–632. https://doi.org/10.1521/pedi.2023.37.5.620