Borderline personality disorder treated with the conversational model: a replication study

Recent work has lead to a greater degree of optimism in the treatment of borderline personality disorder (BPD). This study looks at a group of patients with BPD treated with outpatient psychotherapy using the conversational model of Hobson and Meares. The study group is compared, first, with the original cohort previously reported by Stevenson and Meares [Stevenson J, Meares R. An outcome study of psychotherapy for patients with borderline personality disorder. Am J Psychiatry 1992;149(3):358-62] and, second, with a wait-list “treatment-as-usual” control group. Patients were recruited well after initiation of the program and, hence, can be seen as a group treated under more usual clinical conditions rather than as a cohort subject to the initial wave of research enthusiasm. Subjects were rated at baseline and 12 months on a range of symptomatic, functional, and objective measures. The rate and degree of improvement in the later cohort are very similar to the original 1992 cohort and significantly greater than what is found in the treatment-as-usual controls. We believe that this is the first replication study demonstrating success in treating patients with BPD using an established form of individual psychodynamic therapy delivered in an outpatient setting.