Linehan's (1993)  DBT therapy is considered to be the gold standard.

I think there is considerable evidence for effective dynamic therapies. See for example The outcome of psychodynamic psychotherapies with individuals diagnosed with personality disorders: A systematic review.

doi: http://dx.doi.org/10.1080/02668734.2014.888675

By Haskayne, Donna; Hirschfeld, Rachel; Larkin, Michael

Psychoanalytic Psychotherapy, Vol 28(2), Apr 2014, 115-138.

This review aimed to explore the evidence base of psychodynamic therapy for personality disorder (PD). A systematic approach was applied to the literature search with the use of a clear inclusion/exclusion criteria and a quality assessment checklist. Nineteen studies investigating the use of psychodynamic therapy for PD were reviewed. Four randomised controlled trials (RCT) demonstrated superior results for psychodynamic therapy compared with another type of therapy, two RCTs found that cognitive-based therapies were superior and one RCT found no difference between therapies for PD. Another seven RCTs found positive results for psychodynamic therapies compared with a treatment as usual condition (n = 3) or another dynamic therapy (n = 4). Five non-RCTs were included with mixed findings for treating PD with psychodynamic therapy. Many of the included studies focusing on psychodynamic-based therapies with borderline personality disorder had positive outcomes, and concentrated on mentalisation-based therapy and transference-focused therapy. There were good outcomes for short- and long-term psychodynamic therapies with individuals with PD. Implications for developing services for treating PD are discussed. Research that addresses methodological issues and increases understanding of the ingredients of change in psychodynamic therapy for PD is also recommended. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

A recent book that's not in the CBT mold: Review of Transference-focused psychotherapy for borderline personality disorder: A clinical guide.

doi: http://dx.doi.org/10.1176/appi.ajp.2015.15020158

By Feinstein, Robert E.

The American Journal of Psychiatry, Vol 172(6), Jun 1 , 2015, 589-590.

Reviews the book, Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide by Frank E. Yeomans, John F. Clarkin and Otto F. Kernberg (see record 2015-18407-000). This book is the fourth book in the ongoing evolution of the original work by Kernberg, Clarkin, and Yeomans. Yeomans, the first author and a master clinician, leads this group to clearly and simply describe the theory behind the treatment of borderline personality organization and the use of transference-focused psychotherapy. The book also has accompanying online videos, which demonstrate how to perform a structural diagnostic interview for borderline personality disorder patients, some of the techniques of treatment, and how to deal with affective storms. The book describes how, because of pathological object relations, patients with borderline personality disorder develop symptoms of disturbed interpersonal relations, emotional storms, distorted thinking, and self-destructive behaviors. This book is a synthesis of more than 25 years of original work from the founders of the Personality Disorder Institute of New York. This book is a wonderful blend of theory and techniques offering clinical examples and high-quality useful videos. It will be useful to all those who are interested in treating patients with severe personality disorders. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

Another recent overview: The link between personality theory and psychological treatment: A shifting terrain.

doi: http://dx.doi.org/10.1037/14549-018

By Clarkin, John F.; Cain, Nicole M.; Livesley, W. John

Huprich, Steven K. (Ed), (2015). Personality disorders: Toward theoretical and empirical integration in diagnosis and assessment. , (pp. 413-433). Washington, DC, US: American Psychological Association, xii, 452 pp.

Personality disorders are prevalent (10.56% median prevalence across studies; Lenzenweger, 2008) and debilitating, and they have a powerful impact on work functioning, interpersonal, and intimate relations. However, there are many impediments to the treatment of patients with a personality disorder, not the least of which are the controversies in defining personality disorder, the range of severity across the disorders, the difficulties in identifying the key dimensions of personality dysfunction, and the paucity of treatment research on the majority of the personality disorder types. In this chapter, we briefly review the major theories of personality functioning and personality disorder that have been utilized in empirical efforts to treat patients with various personality disorders. Due to the major focus on borderline personality disorder (BPD) and the paucity of treatment research on the other personality disorders, we focus primarily on the treatments for BPD. We examine the limits of the use of personality disorder theory to date in informing manualized treatments and suggest future avenues of development. With the background of the major theories reviewed in this volume, we examine the link between the major theories of personality disorder and how they inform the clinical tasks of client assessment and treatment articulation. The link between personality disorder theory and treatment is articulated in the treatment manuals that describe treatments for the personality disorders. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

That Is OK, & CBT can help people with BPD identify and change core beliefs and/or behaviors that underlie inaccurate perceptions of themselves and others and problems interacting with others. 

 Hendrika Vande Kemp , I appreciate your taking the time to send these papers.

Dear Abdelfattah,

In addition to Marsha Linehan's Dialectical Behavior Therapy (DBT), I've used James Masterson's developmental object-relations approach to the treatment of borderline personality disorder.

Masterson distinguished short-term supportive counseling from long-term psychotherapy. A lot of clients can benefit from the former and may stop therapy so they don't work on their character structure in an intensive long-term therapy (e.g., a few times a week for several years). 

Clients can function better as result of either treatment approach. Here are some of the references:

http://www.amazon.com/Search-For-The-Real-Self/dp/0029202922

http://www.amazon.com/Psychotherapy-Borderline-Adult-Developmental-Approach-ebook/dp/B00CWWQ0DU/ref=asap_bc?ie=UTF8

http://www.amazon.com/Narcissistic-Borderline-Disorders-Integrated-Developmental-ebook/dp/B00CWWQ1C0/ref=asap_bc?ie=UTF8

i would agree with the earlier answers. One thing to add is that a concurrent mood disorder may be treated with an anti depresssant. However, non compliance or abuse is frequently a factor.It is easy to mis diagnosis these pts and watch the prescribing physician provide an enormous cocktail of medication because "nothing is working". The additional danger is a suicide or

i would agree with the earlier answers. One thing to add is that a concurrent mood disorder may be treated with an anti depresssant. However, non compliance or abuse is frequently a factor.It is easy to mis diagnosis these pts and watch the prescribing physician provide an enormous cocktail of medication because "nothing is working". The additional danger is a suicide or

i would agree with the earlier answers. One thing to add is that a concurrent mood disorder may be treated with an anti depresssant. However, non compliance or abuse is frequently a factor.It is easy to mis diagnosis these pts and watch the prescribing physician provide an enormous cocktail of medication because "nothing is working". The additional danger is a suicide or

DBT currently has the most established evidence base but can be lengthy and expensive. However, a relative newcomer called STEPPS  is a group CBT-based therapy which appears to be producing significant outcomes in the treatment of PD. Medication can assist in reducing mood instability enough to engage in challenging therapy, but generally shows poor outcomes in treating the disorder as a standalone treatment.

Stephen Cheung; Ian Quann & Carl L Tishler; I appreciate your taking the time to write your experiences & answer's.....Its my pleasure, all the best.

I would agree with Ian. Training takes a lot of time and money. I looked at training for 4 people is cost prohibitive for practitioners (DBT team requires 4 people and costs thousands of dollars.

I agree with Dr. Lakvold. Given its large evidence base, DBT is generally thought of as the first line treatment for Borderline PD. Medication is not especially effective for this disorder, although it can be a helpful adjunct to treatments like DBT.

I would note too, that although there is some helpful general information in this thread about treating personality disorders more broadly, I would be careful about generalizing treatments across personality disorders. 

DBT was developed to treat BPD, and is very effective toward this end, but it probably wouldn't be appropriate for someone with schizoid personality disorder.

Thank you, David. I am not a doctor.

In addition to DBT, Schema Therapy also has good evidence for effectively treating BPD.  There are some indications that DBT has a higher rate of client drop out (or refusal to engage to begin with), while ST is often more acceptable to clients.  One place to find some of the citations for the relevant studies is actually on Wikipedia - https://en.wikipedia.org/wiki/Schema_Therapy - there is also an international organization on whose web page you will be able to access more recent information.  

To support Thomas's point above, Seligman and Reichenberg's Selective Effective Treatments (2012, 4th ed.) endorse Schema-Focused CBT therapy as valid treatment for Borderline Personality Disorder.

Dear Abdelfattah,

Every 'mental' disorder (BPD)  patients need to be addressed with dire sensitivities. It is made easier if it is listed as a diagnosable DSM illness.

BPD being a 'serious' mental illness, talking with a highly dedicated and genuinely caring professionals create great trust to the patient.

To the patient, it makes it very worthwhile at one instant to know that someone sympathizes, care and most willing to 'treat' him/her. That's when the talking session, even done once would be very effective.

When this fails, there are several approaches you could apply using -

http://www.borderlinepersonalitydisorder.com/what-is-bpd/treating-bpd/

1. Dialectical Behaviour Therapy (DBT)

- treatments include individual therapy, group skills training and phone coaching

2. Cognitive Behaviour Therapy (CBT)

- treatments include recognizing and changing the patient's belief system

3. Mentalization-based Therapy (MBT)

- treatments include talking out the patient's feeling and addresing it accordingly

4. Transference-focused Therapy (TFP)

- treatment includes situational based scenarios brought upon by the therapist for the patient to apply elsewhere

5. Medications

- not useful but not detriment to include supplement like Omega 3 (not vetted) yet could relieve BPD symptoms nonetheless

6. Self-Care

- educating the patient on the importance of caring for one self  at all time

In order to minimise remissions, always refrain verbally from labeling BPD as a PSY patient to or among other healthcare team. 

This is  because such patient (knowing the gravity of this illness) will either walk away for good or die a brutal death because the doctor-patient trust and privacy have been broken totally.

Best regards - Mariam

Thank you all, for the answers.. appreciate it. Will be writing back in case I need more support or clarity.

Great question. DBT is currently the #1 evidence-based treatment for emotional dysregulation. Since many clients with BPD suffer from severe emotional dysregulation, it is the preferred treatment. In fact, research shows that DBT continues to be effective 2-3 years post treatment. The problem many therapist face is getting their clients to attend the program. It is very detailed and requires the client to have a therapist, do homework assignments and meet frequency with the DBT provider. Hope this is helpful!

Good luck with your project Abdelfattah!!