Integrative Dynamic Treatment for Comorbid Depression and Borderline Conditions

This article summarizes empirical research and theory on the outpatient treatment of comorbid depressed-borderline patients and presents relevant clinical examples in a format intended to be useful to clinicians. Specific focus is placed on a recent article by M. J. Hilsenroth, J. A. DeFife, M. M. Blake, and T. D. Cromer (2007) reporting therapist interventions found more frequently in the psychotherapy of comorbid depressed and borderline patients who reported both statistical and clinically significant gains over the course of treatment. The specific techniques being recommended include providing structure at the outset of therapy, suggesting specific activities or tasks to be done between sessions, maintaining an active focus on treatment topics, supportive exploration of difficult topics and shifts in mood, and examining cyclical relational patterns. This set of techniques might be considered especially useful in the development of an integrative therapeutic approach for treating comorbid depressed and borderline patients in outpatient clinical practice. The applied implications and limitations of this approach are discussed.