Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial
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Background: Transference-focused psychotherapy is a manualised treatment for borderline personality disorder. Aims: To compare transference-focused psychotherapy with treatment by experienced community psychotherapists. Method: In a randomised controlled trial (NCT00714311) 104 female out-patients were treated for 1 year with either transference-focused psychotherapy or by an experienced community psychotherapist. Results: Significantly fewer participants dropped out of the transference-focused psychotherapy group (38.5% v. 67.3%) and also significantly fewer attempted suicide (d = 0.8, P = 0.009). Transference-focused psychotherapy was significantly superior in the domains of borderline symptomatology (d = 1.6, P = 0.001), psychosocial functioning (d = 1.0, P = 0.002), personality organisation (d = 1.0, P = 0.001) and psychiatric in-patient admissions (d = 0.5, P = 0.001). Both groups improved significantly in the domains of depression and anxiety and the transference-focused psychotherapy group in general psychopathology, all without significant group differences (d = 0.3–0.5). Self-harming behaviour did not change in either group. Conclusions: Transference-focused psychotherapy is more efficacious than treatment by experienced community psychotherapists in the domains of borderline symptomatology, psychosocial functioning, and personality organisation. Moreover, there is preliminary evidence for a superiority in the reduction of suicidality and need for psychiatric in-patient treatment.
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There is a clear trend towards new kinds of control conditions such as CTBE or guideline-oriented treatments.
“There is a clear trend towards new kinds of control conditions such as CTBE (Linehan 2006; Doering 2010) or guideline-oriented treatments (Bateman 2009;McMain 2009).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
Random sequence generation in Doering 2010 was at low risk of selection bias; random numbers were used, with matching after inclusion of the 35th patient according to severity of self-harming behaviour during the last year and personality organisation.
“Random sequence generation (selection bias) Low risk Use of random numbers, matching after inclusion of 35th patient according to severity of self-harming behaviour during the last year and personality organisation (Doering 2010, personal communication.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
Allocation concealment in Doering 2010 was at low risk of selection bias; results of first assessments were sent to a researcher outside the two study centers who performed the randomization.
“Allocation concealment (selection bias) Low risk “The results of the first assessments [screening for inclusion criteria] were sent to a researcher outside the two study centers who performed the randomization.”(Doering 2010, p. 5)”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
Doering 2010 found no statistically significant difference between treatment and control in any self-harming behaviour.
“or any self-harming behaviour (RR 1.09; N = 104, 95% CI 0.84 to 1.40; Analysis 1.9)”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
Blinding of outcome assessment in Doering 2010 was at low risk of detection bias; research assistants who conducted assessments before randomization and after one year of treatment were blinded.
“Blinding of outcome assessment (detection bias) All outcomes Low risk “Research assistants who conducted assessments before randomization and after one year of treatment were blinded for the”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
Doering 2010 found no statistically significant difference between treatment and control in the proportion of participants with any suicidal act.
“Doering 2010 report data indicating no statistically significant difference in the proportion of participants with any suicidal act (RR 0.64; N = 104, 95% CI 0.27 to 1.51; Analysis 1.7)”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
Doering 2010 report data indicating a marginal, statistically nonsignificant difference between the groups in terms of general psychopathology (SMD 0.08; N = 104, 95% CI -0.31 to 0.46; Analysis 1.16).
“Doering 2010 report data indicating a marginal, statistically nonsignificant difference between the groups in terms of general psychopathology(SMD 0.08; N = 104, 95% CI -0.31 to 0.46; Analysis 1.16).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
For Doering 2010, treatment adherence was rated low risk because video recordings of all EG sessions were performed and used in group supervision, every case was supervised at least every four to six weeks, and experienced community psychotherapists attended supervisions according to their usual routine.
“Video recordings of all [EG] sessions were performed and used in the group supervision.[...] Every case was supervised at least every four to six weeks.[...] Experienced community psychotherapists [i.e., CG therapists] attended supervisions according to their usual routine.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
For Doering 2010, research assistants who conducted assessments before randomization and after one year of treatment were blinded for the therapy delivered.
“Research assistants who conducted assessments before randomization and after one year of treatment were blinded for the therapy delivered.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
For Doering 2010, allegiance effect was judged unclear risk because some study authors are experienced TFP therapists, but none was personally involved in treatment development.
“Allegiance effect improbable? Unclear risk Some of the study authors are experienced TFP therapists, but none was personally involved in treatment development.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
For Doering 2010, attention bias was rated low risk because every participant was provided the specifically full amount of necessary attention.
“Attention bias: equal amounts of attention to all Low risk Less attention may have been paid to CG patients depending on the CTBE therapist's main orientation; however, every participant was provided the specifically full amount of necessary attention.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
Doering 2010 found a marginal, statistically nonsignificant difference between groups regarding anxiety (SMD 0.04; N = 104, 95% CI -0.35 to 0.42).
“Doering 2010 report data indicating a marginal, statistically nonsignificant difference between the groups regarding anxiety (SMD 0.04; N = 104, 95% CI -0.35 to 0.42; Analysis 1.15).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
Doering 2010 reported a small, statistically non-significant difference between groups in overall functioning (SMD 0.34; N = 104; 95% CI -0.05 to 0.73).
“Doering 2010 report data indicating a small, statistically nonsignificant difference between the groups in terms of overall functioning (SMD 0.34; N = 104, 95% CI -0.05 to 0.73; Analysis 1.17).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
Doering 2010 reported a moderate, statistically significant effect in favour of TFP for overall BPD severity reduction (SMD -0.55; N = 104, 95% CI -0.95 to -0.16; Analysis 1.1).
“Data reported by Doering 2010 indicate a moderate, statistically significant effect in favour of TFP concerning overall BPD severity reduction (SMD -0.55; N = 104, 95% CI -0.95 to -0.16; Analysis 1.1).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Doering 2010
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- Authors
- Doering, S., Hörz, S., Rentrop, M., Fischer-Kern, M., Schuster, P., Benecke, C., Buchheim, A., Martius, P., & Buchheim, P.
- Affiliations
- Innsbruck Medical University (AT)
- Technical University of Munich (DE)
- Medical University of Vienna (AT)
- Universität Innsbruck (AT)
- Corresponding author
- Doering, Stephan
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2010-05
- Volume
- 196
- Issue
- 5
- Pages
- 389-395
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2165687185
- Cited by
- 440
- References
- 28
- Citations by year
- 2026: 13 · 2025: 18 · 2024: 24 · 2023: 24 · 2022: 20 · 2021: 23 · 2020: 36 · 2019: 32 · 2018: 28 · 2017: 32 · 2016: 28 · 2015: 28 · 2014: 30 · 2013: 37 · 2012: 34
- FWCI
- 36.29
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- Funders
- Oesterreichische Nationalbank (10636)
- Technische Universität München
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- transference-focused psychotherapy, borderline personality disorder, psychotherapy efficacy, suicidality, psychosocial functioning, treatment discontinuation, self-harm
- MeSH terms
- Adolescent, Adult, Borderline Personality Disorder, Combined Modality Therapy, Community Mental Health Services, Female, Humans, Middle Aged, Psychiatric Status Rating Scales, Psychotherapy, Psychotropic Drugs, Transference, Psychology, Treatment Outcome, Young Adult
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