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Borderline personality disorder (BPD) and substance use disorders commonly co-occur. Co-occurrence is associated with increased morbidity and
mortality, and decreased treatment response and retention, compared with either condition alone. The primary objective of this poster is to describe the preliminary findings of an ongoing pilot thirty-month controlled study that assesses a modified form of psychodynamic psychotherapy for persons with co-occurring BPD and alcohol use disorders. Alcohol use disorders were targeted for treatment over other substance use disorders due to their high prevalence and the lack of previous controlled treatment trials specific to that population. Although the study is not powered to detect statistically significant between-group differences, a six-month outcome analysis was undertaken to determine whether preliminary findings and effect sizes are sufficiently favorable to warrant further research.
Dynamic deconstructive psychotherapy (DDP; Gregory and Ramen 2008) is a time-limited, manual-based treatment that was developed for patients with borderline personality disorder who are particularly difficult to engage in a therapeutic relationship, including those having co-occurring substance use disorders. The model employs elements of object relations theory, deconstruction philosophy, and neurocognitive research to delineate specific integrative functions of the self that are targeted for treatment over sequential stages (Gregory 2004), including functions of association, attribution, and alterity. The treatment aims to support integrative self-functions and to deconstruct pathological attributions that can interfere with a therapeutic alliance (Gregory 2005). The therapist attempts to foster verbalization and integration of patient experiences, narratives, and attributions while remaining generally nondirective and nonjudgmental, and relying on moment-by-moment affective responses of both patient and ther