Good Psychiatric Management and Dialectical Behavior Therapy: A Clinician's Guide to Integration and Stepped Care

The impetus for writing Good Psychiatric Management and Dialectical Behavior Therapy: A Clinician's Guide to Integration and Stepped Care was the realization that the availability of specialized care for borderline personality disorder (BPD) is far outstripped by the number of patients who need treatment. This manual, edited by experts on BPD, provides a framework for implementing a stepped care model in settings where access to specialized treatments is limited. The authors contend that the principles of good psychiatric management (GPM) represent a basic foundation that all clinicians can learn and that combined with dialectical behavior therapy (DBT), one of the most effective newer treatment modalities, progress can indeed be realized. The book prioritizes pragmatism by suggesting what works in terms of reasonable evidence, practical allocation of public health resources, and real-world clinical experience implementing evidence-based treatments for BPD.

The book is structured to enhance understanding and the acquisition of basic skills: - An introductory chapter delivers a brief overview of both GPM and DBT, explaining in broad strokes how BPD is conceptualized in each model. Later chapters address the common principles found in both GPM and DBT -- principles that any generalist clinician can incorporate into their practice, including clinician stance, treatment organization, and a strategy for managing crises.- The stepped care model for BPD, is introduced and explored, with emphasis on clinical stage and available resources. In addition, the book presents a menu of possible ways clinicians and programs can use GPM, DBT, and other specialist psychotherapy for BPD.- Two tool kits are supplied, one each for GPM and DBT. These tool kits summarize the top skills and techniques in both treatment modalities for clinicians who are interested in using them in their practices.- A full set of case illustrations is included, each depicting the application of DBT and GPM in common clinical scenarios. These vignettes demonstrate how DBT and GPM can be integrated into primary care settings, emergency rooms, and general mental health settings where specialized psychotherapies for BPD are either not available or not well suited.

Aimed at general psychiatrists, therapists, social workers, mental health nurses, psychiatry residents, family physicians, psychologists, and other mental health clinicians who practice in communities where evidence-based treatments for BPD are difficult to access, Good Psychiatric Management and Dialectical Behavior Therapy enhances the clinician's ability to provide not only treatment but also hope.

About author(s):

Anne K.I. Sonley, J.D., M.D., FRCPC, is Lecturer at the University of Toronto, and Psychiatrist at the Borderline Personality Disorders Clinic at the Centre for Addiction and Mental Health in Toronto, Ontario, Canada.

Lois W. Choi-Kain, M.D., M.Ed., is Director of the Gunderson Personality Disorders Institute in Belmont, Massachusetts, and Assistant Professor of Psychiatry at Harvard Medical School in Boston, Massachusetts.