Psychotherapy is often used in treating borderline personality disorder. Four types of psychotherapy have been studied for their effectiveness with this population. These therapies include psychoanalysis, analytically oriented psychotherapy, dynamically oriented psychotherapy, and supportive psychotherapy. All four types have been shown to be effective, and the choice of style depends on the training of the therapist. According to Goldstein , “because of the borderline patients’ problems with many of their ego functions, their proclivity to regress in the unstructured setting, and their difficulty in trust and establishing and maintaining a therapeutic alliance, attempts at psychoanalysis are difficult and fraught with dangers”.
Treating an adolescent with a Personality Disorder , specifically BPD, is a challenge for a counselor. Children often attempt to manipulate the counselor and undermine the treatment. Recommendations indicate that someone who counsels these children needs to tailor the therapy to be reality intensive on concrete ways that the patient is currently misinterpreting information. Confrontation and coping skills training may also be used with adolescents. These provide a flexible view of reality that children with BPD do not utilize. Another method used with children is Dialectical Behavior Therapy, as mentioned previously. It works with adolescents to reduce behaviors that lead to premature termination of the counseling relationship. It also reduces behaviors that inhibit the individual from interacting with peers in a positive manner
According to Alcarnon and Leetz , culture can be shown as a factor in the pathogenic, pathoplastic, diagnostic, and service aspects of personality disorders. Specifically, these researchers focused on borderline PD, and studied the role of culture in psychotherapeutic treatment. Their study found that culture applies to choice of therapy, the therapeutic process, the issues of boundaries, defense mechanisms, treatment settings, intercurrent suicidal behavior, and use of co-therapies. The diagnosis of BPD originated in Europe, but it was in the United States where efforts to describe the disorder were first undertaken. Research on culture and psychotherapy has shown that culture permeates the transference-counter-transference field, a term used to describe the therapy process. In other words, the cultural background of both the patient and the doctor affect the treatment. Also, culture influences the role of family in the cause of personality problems, and in the degree of social networks available for use in treatment. Finally, the researchers note, “variations and stereotypes of both therapists and patient respond to different degrees of acculturation, interethnic or intragroup distortions in a pluralistic society.