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The unified protocol for anxiety and depression with comorbid borderline personality disorder: a single case design clinical series

Published online by Cambridge University Press:  31 July 2019

Michelle E. Lopez Open the ORCID record for Michelle E. Lopez [Opens in a new window] ,
Steven R. Thorp ,
Matthew Dekker ,
Andrew Noorollah ,
Giovanna Zerbi ,
Laura A. Payne ,
Emily Meier  and
Jill A. Stoddard
Michelle E. Lopez*
Affiliation:
California School of Professional Psychology at Alliant International University, 10455 Pomerado Road, San Diego, CA 92131, USA
Steven R. Thorp
Affiliation:
California School of Professional Psychology at Alliant International University, 10455 Pomerado Road, San Diego, CA 92131, USA
Matthew Dekker
Affiliation:
California School of Professional Psychology at Alliant International University, 10455 Pomerado Road, San Diego, CA 92131, USA
Andrew Noorollah
Affiliation:
California School of Professional Psychology at Alliant International University, 10455 Pomerado Road, San Diego, CA 92131, USA
Giovanna Zerbi
Affiliation:
University of California, San Diego, 1899 McKee Street, Ste 126, San Diego, CA 92110, USA
Laura A. Payne
Affiliation:
Pediatric Pain Program, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, 22-464 MDCC, Los Angeles, CA 90095-1752, USA
Emily Meier
Affiliation:
University of California, San Diego, 9500 Gilman Drive 0664, La Jolla, CA 92093-0664, USA
Jill A. Stoddard
Affiliation:
California School of Professional Psychology at Alliant International University, 10455 Pomerado Road, San Diego, CA 92131, USA
*
*Corresponding author. Email: [email protected]
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Abstract

This study used a single case experimental design to investigate the use of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) among a sample of individuals with depression and anxiety who also presented with borderline personality disorder (BPD). Eight women received individual treatment with the UP over the course of 14–16 treatment sessions, and were assessed for anxiety and depression severity on a weekly basis over a 2–6 week baseline period and throughout treatment. Three of the eight participants demonstrated reliable pre- to post-treatment clinical improvements on depression and stress scales, and one participant demonstrated a reliable reduction on an anxiety scale. Two participants demonstrated a reliable improvement in overall anxiety. The results indicate that the UP applied to individuals diagnosed with primary BPD may lead to clinical improvement in depression, stress and anxiety for some individuals. However, the majority of individuals with BPD in our sample did not show strong improvement, and this suggests the need for additional sessions of UP or an intervention that focuses on the symptoms of BPD specifically for some women.

Key learning aims

  1. (1) To describe the applicability of the Unified Protocol in the treatment of individuals with borderline personality and co-occurring anxiety or depression.

  2. (2) To understand the value of utilizing a transdiagnostic approach as an alternative to diagnosis-specific approaches to treatment.

  3. (3) To identify the four core modules of the Unified Protocol and describe the general format for individual treatment.

Keywords

borderline personality disordercomorbid disordersemotional disorderspsychotherapytransdiagnostictreatment outcome
Type
Case Study
Information
the Cognitive Behaviour Therapist , Volume 12 , 2019 , e37
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019. 

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References

Further reading

Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205–230.CrossRefGoogle Scholar
Ellard, K. K., Fairholme, C. P., Boisseau, C. L., Farchione, T. J., & Barlow, D. H. (2010). Unified protocol for the transdiagnostic treatment of emotional disorders: protocol development and initial outcome data. Cognitive and Behavioral Practice, 17, 88–101.CrossRefGoogle Scholar
Thompson-Hollands, J., Sauer-Zavala, S., & Barlow, D. H. (2014). CBT and the future of personalized treatment: a proposal. Depression and Anxiety, 31, 909–911.CrossRefGoogle ScholarPubMed

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