The concept of being a TFP therapist has evolved over the years. When Otto Kernberg first wrote about borderline conditions and how to treat them, he considered his contributions to be modifications and refinements of general psychoanalytic technique. In those early days, in the late 1970’s and the 1980’s, before the more specific description of TFP emerged from the Personality Disorders Institute (PDI) in New York, psychoanalysts and psychoanalytic psychotherapists integrated elements of what would later become TFP into their approach to treating patients with borderline pathology. At that time, there was no formal TFP training program.
Then two developments occurred: First, in the late 1980’s, the team at the PDI became more aware of the coherence of TFP as a model within psychoanalytic psychotherapy – involving the treatment contract, the therapist’s level of activity, the hierarchy of thematic priorities, the particular use of technical neutrality, the conceptualization of intrapsychic conflicts as represented by dissociated object relations dyads, the “experience-near” model of interpretation – among other elements. This awareness led to efforts to describe TFP as a form of therapy that has its own internal consistency and could be taught as a defined model of therapy within the psychoanalytic range. These efforts are best represented by the series of manuals produced by the PDI (Kernberg et al. 1989, Clarkin et al. 1999, Yeomans et al. 2001, Clarkin et al. 2006).
Second, the field of mental health began to emphasize the importance of providing an evidence base to support the efficacy of psychotherapy. The need for research combined with the awareness of the coherence of TFP as a model of therapy and increased the need to define it clearly as a method so that adherence to the model could be measured.
As the above developments took place, the PDI began to respond to requests to teach TFP at other sites such as Munich, Quebec, and the Netherlands. The team at the PDI learned a great deal from these initial teaching experiences and has had to address certain questions. Principle among these questions was the relation of TFP to psychoanalysis per se. In some settings, TFP was viewed as an extension of psychoanalysis that should be taught only to therapists who had completed analytic training. Increasingly, however, it became evident that TFP, with its clear explication of psychodynamic concepts, can help introduce the techniques of psychodynamic therapy to therapists who already have acquired a basic understanding of the psychoanalytic concepts of the unconscious, intrapsychic conflicts, defense mechanisms and their relation to symptoms, etc. Evidence of this is seen in the fact that TFP has become a part of the basic psychotherapy training in a number of psychiatric residency programs and psychology graduate programs.
Given the above evolution of TFP, we must now address the distinction between therapists who use TFP principles and those who are TFP therapists.
1) Therapists who use TFP principles: As the authors of treatment manuals, we understand and hope that a broad range of therapists will learn about TFP and incorporate its principles and techniques in their work with BPD patients. Some of these therapists apply the entire model in their work with patients. Others, including some of our students in psychiatry training programs, have emphasized the usefulness of applying certain principles and techniques of TFP in their work with borderline patients in treatment settings other than twice-per-week individual therapy. Based on their encouragement, we have begun to write about this topic.
In addition to reading the TFP manuals and related articles, therapists interested in learning about TFP can take advantage of the lectures and workshops on TFP that are offered at many psychiatric and psychological congresses and conventions. A list of these is available on the “Upcoming Events” section of this website.
In summary, a therapist can learn a great deal about TFP through reading and conferences. However, a major limitation of learning TFP outside the context of a full training program is the lack of an on-going supervision group.
2) Therapists seeking formal training in TFP: In-depth training in TFP is generally offered in one of two formats. In either format, full training includes didactic instruction in combination with supervision of cases.
Format 1 – Established TFP centers offer didactic trainings that vary in length from one to two years. Depending of the logistics of the local centers, the training courses may meet as seminars on a weekly basis or may consist of a series of more intensive weekend workshops. These centers include:
The Personality Disorders Institute
The Columbia Center for Psychoanalytic Research and Training
TFP–New York (formerly the Personality Studies Institute)
TFP Group Vienna
TFP Institute Munich
Institute of Psychotherapy Berlin
Amsterdam, Maastricht, Leiden/The Netherlands
Psychiatric Clinic Münsterlingen
Format 2 – In locations where a core group of therapists are interested in organizing TFP training, the group can contact certified TFP Supervisors from one of the above locations to discuss the development of a training in their own location. Such trainings usually involve two intensive 3-day workshops separated by approximately 6 months and then a period of supervision by internet. Local trainings of this sort have led to the establishment of most of the TFP centers listed above. More recent local trainings have taken place in Parma, Barcelona, Turin, Mexico City, and Bilbao.
For therapists who are not able to attend training at one of these centers, there is the option of taking a course on-line. Therapists interested in full training as a TFP therapist should seek opportunities listed on this website. Details about the training centers can be found here.
Clarkin JF, Yeomans FE, Kernberg OF (1999). Psychotherapy for Borderline Personality. New York: John Wiley and Sons.
Clarkin JF, Yeomans FE, Kernberg OF (2006). Psychotherapy for Borderline Personality. Focusing on Object Relations. Arlington: American Psychiatric Publishing.
Kernberg OF, Selzer MA, Koenigsberg HW, Carr AC, Appelbaum AH (1989). Psychodynamic Psychotherapy of Borderline Patients. New York: Basic Books.
Yeomans FE, Clarkin JF, Kernberg OF (2002). A Primer on Transference-Focused Psychotherapy for the Borderline Patient. Northvale, NJ: Jason Aronson.
Frank Yeomans, MD, TFP–New York, LLC, 122 East 42nd Street, Suite 3200, New York, NY 10168, USA