Borderline Personality Disorder Initiative (BPDI)
The Borderline Personality Disorder Initiative (BPDI) at the Semel Institute at UCLA is dedicated to the treatment of borderline personality disorder and to the education of clinicians in evidence-based treatment methods for this disorder. BPDI offers an innovative combination of Mentalization Based Therapy, medication management, psychoeducational services and follow- up psychotherapy sessions. All are aimed at enhancing self-reliance and social functioning, while reducing the need for hospitalization.
What is Borderline Personality Disorder (BPD)?
Borderline Personality Disorder (BPD) is a mental health disorder characterized by dysfunction in the regulation of emotion, behavior, relationships, impulse control and one’s sense of self. It is associated with substantial impairments in work and family life. It involves sometimes rapid variability in moods that leads to disruption in many settings and sometimes leads to harmful behaviors including suicidality. Individuals with BPD may present with a combination of difficulties that often include depression, anxiety, post-traumatic symptoms, substance abuse and/or eating disorders. These conditions can manifest themselves through recurring fears of abandonment, angry outbursts, identity disturbances, self-damaging behavior or suicidality, intolerance of being alone and/or chronic feelings of emptiness or boredom. BPD appears prevalent in around 2% of the general population. In the community of those who regularly seek mental health care, the prevalence is thought to be as high as 20%.
1) 18 month Outpatient Mentalization Based Therapy Program
This outpatient group is based on the Mentalization-Based Treatment Model developed by Anthony Bateman, MA, FRCPsych and Peter Fonagy, PhD, FBA. Each patient is seen weekly for individual psychotherapy by a member of the team (psychologist, psychiatrist or resident psychiatrist). In addition, each patient attends a group therapy session or group skills training session for 90 minutes. This group is led by two team members (a resident psychiatrist and a senior psychiatrist). Patients also receive medication management services from one of our team resident psychiatrists who operate under the supervision of our Clinic Director. Lastly, each patient will be asked to fill out some brief questionnaires online every week and meet with the research coordinator every 3 months for additional psychological assessments. These questionnaires and psychogical assessments are an opportunity for us to learn more about your experience in the program and to make any changes to improve the program. Clinic sessions are held Tuesday's from 1pm -5pm and Thursday's 5pm-7pm. Accommodations can be made. We require 24 hours notice for cancellation of appointments. All patients agree that they will use this clinic as their only therapy source and psychiatric medication management source. We accept new patients every year starting in late June. However, a spot may open during the 18 month course.
2) Psychoeducational Menatlization Based Therapy Program
This group is a 12 week psychoeducation class focused on learning about Mentalization Based therapy. The psychoeducation group is open to all individuals. The individual is aware of the purpose and focus of treatment and knows about the primary aims. The therapist attempts to describe to the individual the end-result of the diagnostic and functional evaluation. Based on personal episodes from the person's life story, the mentalization perspective is used, in collaboration with the person, to arrive at a mentalization-based formulation. The person will be asked to participate in exercises and activities during the class to practice the MBT approach. This psychoeducational class is offered multiple times during the year. All patients who join the 18 month program are asked to complete the psychoeducational MBT group before starting the 18 month program.
*Clients must commit to either track for the entire length of the program.
What is Mentalization Based Therapy? What is Mentalizating?
Mentalizing is the process by which we make sense of each other and ourselves, implicitly and explicitly, in terms of subjective states and mental processes. It is a profoundly social construct in the sense that we are attentive to the mental states of those we are with, physically or psychologically. Given the generality of this definition, most mental disorders will inevitably involve some difficulties with mentalization, but it is the application of the concept to the treatment of borderline personality disorder (BPD). Mentalization based treatment (MBT) is a time-limited treatment which structures interventions that promote the further development of mentalizing. It has been tested in research trials and found to be an effective treatment for BPD when delivered by mental health professionals. Mentalization-based treatment is a model of psychodynamic therapy that aims to enhance the individual’s capacity to represent thoughts, feelings, wishes, beliefs and desires in themselves and in others in the context of attachment relationships. The therapist will usually not give advice or an opinion. Instead, your therapist will help you explore your internal states and help you form new ways of mentalizing. Previous studies have shown that patients in the mentalization based therapy programs had larger reductions in deliberate self-harm, suicide attempts, anxiety, and depression, and better social functioning, than the patients who received standard treatment.