Comparing Schema and Dialectical Therapy for BPD: Reflection

This assignment is a refined reflection comparing Schema Therapy and Dialectical Behavior Therapy (DBT) for the treatment of Borderline Personality Disorder (BPD). The reflection begins by defining BPD and its symptoms, including fear of abandonment, unstable relationships, self-mutilation, and suicidal ideation. It then describes Schema Therapy as an integrative approach incorporating cognitive-behavioral, attachment, and emotion-focused techniques, but notes its higher cost. Conversely, the assignment highlights DBT as an evidence-based and cost-effective psychotherapy, particularly effective in reducing self-destructive behaviors and suicidal ideation by altering negative thought patterns. The assignment references a study by Fassbinder et al. (2018) that supports the effectiveness of DBT in reducing suicidal thoughts and self-mutilation, concluding that DBT is the more effective treatment for BPD.

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REFINED REFLECTION TEMPLATE Use 1 page for your 250 words. References can be on page 2. Use no more
than 5 references. Do not change format (Arial 12 single spacing).
The borderline personality disorder is considered as a mental health disorder where individuals
feel an intense fear of abandonment or instability and they experience difficulties in being alone
(Schwartz-Salant, 2018). The symptoms include self-mutilation and suicidal ideation, the pattern of
unstable intense relationships, issues associated with self-identity and self-imaging (Schwartz-Salant,
2018).
Schema therapy is integrative psychotherapy used for the treatment of personality disorders.
In this psychotherapy, cognitive-behavioral, attachment and emotion-focused traditions to alter the
mental state of the patient in the borderline disorder (Bateman, Gunderson & Mulder, 2015). Since it
incorporates different dynamics, it is expensive for the population belongs to low socio-demographic
status.
On the other hand, dialectical therapy is evidence-based psychotherapy, specifically used
for the reduction of self-destruction and suicidal ideation in patients. It alter negative thinking patterns
for positive behavioral changes (Barnicot et al., 2016). Hence, it is considered as the most cost-
effective therapy. This therapy is the most effective since in this case professional roles are not
limited and used approach, specifically for limiting self-mutilation unlike schema therapy with different
elements.
Fassbinder et al. (2018), conducted a randomized control trial where 160 BPD patients
were recruited where one group received dialectical therapy and another received schema. The result
of the study suggested that that the suicidal thoughts and mutilation has been reduced in patient who

received dialectical therapy. The reason can be the psychodynamic educational approach for
addressing the issue.
Hence, it can be concluded that for reduction of self-mutilation and suicidal ideation of
borderline personality disorder, dialectical therapy is most effective (Linehan et al., 2018).
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References:
Barnicot, K., Gonzalez, R., McCabe, R., & Priebe, S. (2016). Skills use and common treatment
processes in dialectical behaviour therapy for borderline personality disorder. Journal of
Behavior Therapy and experimental psychiatry, 52, 147-156.
Bateman, A. W., Gunderson, J., & Mulder, R. (2015). Treatment of personality disorder. The
Lancet, 385(9969), 735-743.
Fassbinder, E., Assmann, N., Schaich, A., Heinecke, K., Wagner, T., Sipos, V., ... & Schweiger, U.
(2018). PRO* BPD: effectiveness of outpatient treatment programs for borderline personality
disorder: a comparison of Schema therapy and dialectical behavior therapy: study protocol for
a randomized trial. BMC psychiatry, 18(1), 341.
Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., ... & Murray-
Gregory, A. M. (2015). Dialectical behavior therapy for high suicide risk in individuals with
borderline personality disorder: a randomized clinical trial and component analysis. JAMA
psychiatry, 72(5), 475-482.
Schwartz-Salant, N. (2018). The borderline personality: Vision and healing. In Psychopathology (pp.
157-204). Routledge.
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