Treating the Borderline Patient: A Contract Based Approach

The successful treatment of the borderline patient is one of the greatest challenges to psychotherapists. Clinicians and researchers alike are becoming aware that the treatment contract plays a critical role in effective therapy with these patients. Recent research indicates there is a correlation between skillful handling of the contract-setting phase of therapy and the length of time borderline patients stay in treatment. Even more important, the contract can help keep therapy on track. Here at last is a book that focuses on this important therapeutic tool.Expanding on the object relations approach to borderline pathology developed by Otto Kernberg and described in the pathbreaking Psychodynamic Psychotherapy of Borderline Patients, the authors stress the practical implications of the contract, illustrating how it provides a microcosm of the patient's inner world and an opportunity for the therapist to gain an early understanding of the nature of the patient's resistances.A major focus of the book is to help the therapist predict patient behaviors that will threaten treatment, either by ending the treatment or by derailing it from its goal. Thus the book serves to both anticipate and trouble-shoot problems.