Recommendations for beginner DBT or CBT texts for working with borderline clients

[neurofreakout]

I am a clinical psychology PhD student (neuropsychology focused) starting a therapy placement in an adult community mental health setting. As I collect my clients, several of them are presenting with BPD or BPD traits. My limited therapy experience has used CBT frameworks, so I am looking to expand my knowledge on treating and working with borderline clients. Can anyone recommend good beginner-level CBT or DBT guides/manuals/texts for working with borderline presentations specifically. My clinical supervisor was vague when I asked for resources, but I will ask again. In the meantime, some guidance on recommended books would be very much appreciated so that I can learn and prepare. Thanks!

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[R. Matey]

Marsha Linehan's DBT skills workbook and manual have been go to's for me in the past. I also have Matthew McKay's, but I like Linehan's way better.

 

[smalltownpsych]

Agree with reading Linehan. I also find Kernbergs work to be helpful https://a.co/d/3NNAloF
Lineman’s treatment is meant to be delivered by a team so in some cases it is less useful. It also doesn’t delineate specifics of psychotherapy strategies and techniques as much. I tell my supervisees to work very hard on client centered techniques for all clients first and then we will develop the conceptual framework together as they learn more.

 

[DynamicDidactic]

An Otto Kernberg sighting, wowza!

OP, what is it about working with BPD or BPD traits do you feel you need help with? Is it how you can help them or how do you handle yourself when interacting with the client?

If I were to take a DBT approach, I am asking are you looking at WHAT to do or HOW to do it?

For the HOW: IMO, using a CBT approach and the dialectical nature of DBT is probably the best way to handle cases related to BPD. If you are not doing DBT (with a Team), I am unsure it is necessary to learn the ins and outs of the treatment and the skills. However, looking over the principles of DBT and being behavioral in your role as the therapist may be the best approach. Nowadays, the internet can give you the principles of DBT and perhaps specifically search about what are dialects and the actual dialects in DBT. Though, solid training and supervision in behavioral theory and intervention will help a great deal.

For the WHAT: DBT skills training, depending on the client (BPD can look very different person-to-person), in emotion regulation and interpersonal effectiveness may also give you some tools to use in session.

 

[cara susanna]

I also think it's important to differentiate between DBT skills training (which you can learn easily enough by picking up a manual) and the DBT full model therapy framework (which requires a lot more training, and a team to implement it with)

 

[psycho1391]

also find Kernbergs work to be helpful https://a.co/d/3NNAloF

2nd Kernberg

This book is so helpful in understanding the pathology and giving some ways to work with borderline patients

 

[R. Matey]

Important to note that the OP's setting is a CMHC where resources for fidelity DBT are likely limited.

 

[ela]

Given that you're working in a CMHC and, as noted above, resources may be limited, I would suggest Gunderson;

Handbook of Good Psychiatric Management for BPD

APA - Handbook of Good Psychiatric Management for Borderline Personality Disorder

www.appi.org

 

[missmatched]

The DBT manual by Linehan is monstrously large and long. You can learn most of DBT by simply reading the worksheets that are handed out to clients (DBT Skills Training Handouts and Worksheets Second Edition, Spiral-Bound Paperback). That is where I would start for DBT.

For CBT, Judith Beck's book CBT Basics and Beyond (3rd edition). You can also look at the sessions of the Cognitive Processing Therapy (CPT) manual (Cognitive Processing Therapy for PTSD: A Comprehensive Manual Second Edition) which covers CBT, including the worksheets on the A-B-C model, Patterns of Problematic Thinking, and Challenge Questions. CPT does a good job of covering the basics of CBT. Just be sure not to mix in the trauma elements of CPT into CBT if not necessary for your client.

 

[R. Matey]

The DBT manual by Linehan is monstrously large and long. You can learn most of DBT by simply reading the worksheets that are handed out to clients (DBT Skills Training Handouts and Worksheets Second Edition, Spiral-Bound Paperback). That is where I would start for DBT.

I can usually tell when someone hasn't read the theoretical framing for their intervention. My guess is that many patients can as well.

 

[MCParent]

The DBT manual by Linehan is monstrously large and long. You can learn most of DBT by simply reading the worksheets that are handed out to clients (DBT Skills Training Handouts and Worksheets Second Edition, Spiral-Bound Paperback). That is where I would start for DBT.

This sounds akin to thinking you’re learning to do research by knowing what buttons to press in SPSS rather than understanding what you’re doing, tbh

 

[missmatched]

This sounds akin to thinking you’re learning to do research by knowing what buttons to press in SPSS rather than understanding what you’re doing, tbh

They asked for beginner level. AKA, where to begin.

 

[R. Matey]

They asked for beginner level. AKA, where to begin.

Yeah, you begin with the theory.

 

[smalltownpsych]

I guess I know now why so many people out there who say they do DBT know so little about it. At the core of DBT are behavioral principles and the dialectic speaks to the challenge of getting a person to reduce negative or unwanted behaviors without inadvertently reinforcing the emotional responses that leads to some of the behaviors. Without understanding the strategy then the tools aka worksheets are useless and probably harmful. Maybe a reason that I have so many patients who say they hate DBT because when I dig into it a little I find that they were just being punished for bad behaviors. Anyone could do that without reading any difficult books.