Borderline personality disorder (BPD) is a heterogeneous condition characterized by emotion dysregulation, interpersonal dysfunction, impulsivity, identity disturbance, and elevated rates of co-occurrence with other mental health conditions. Criterion B of the Alternative Model of Personality Disorders (AMPD) conceptualizes BPD symptoms as manifestations of dimensional personality traits, particularly negative affectivity, antagonism, and disinhibition. BPD Compass (Cognitive-behavioral Modules for Personality Symptoms) is an 18-session modular cognitive-behavioral intervention designed to target these higher-order personality dimensions and their underlying maintenance mechanisms. This article presents a detailed case study illustrating the application of BPD Compass with a 25-year-old bisexual Appalachian woman diagnosed with BPD, persistent depressive disorder, binge eating disorder, and subclinical social anxiety disorder. Treatment integrated values clarification, cognitive flexibility, behavioral skills, and mindfulness strategies tailored to the patient's cultural and identity-related experiences. Throughout treatment, interventions were personalized to address the impact of Appalachian cultural norms, minority stress related to sexual identity, emotional avoidance, interpersonal mistrust, and impulsive coping behaviors. By posttreatment, the patient demonstrated substantial reductions in BPD symptom severity, with Zanarini Rating Scale scores decreasing from 23 to 6. She no longer met criteria for binge eating disorder or clinically significant social anxiety symptoms and reported meaningful improvements in emotion regulation, interpersonal functioning, and impulse control.
ABSTRACT Objective In light of limited teaching resources and the essential need for Indigenous‐focused learning material, this study sought to contribute to the development of culturally appropriate support for First Nations students training as family therapists. Drawing on the wisdom and experience of graduate students of an integrated family therapy training program that embeds Australian Aboriginal culture and Aboriginal wisdom within mainstream curriculum, we explore the transformative elements of course curriculum and teaching process. Method As part of the course, First Nations students prepared reflective essays on their learnings related to culturally adapted systemic frameworks for working with Australian Indigenous families, including ethics of practice, and impacts for self. These essays ( n = 9) were subject to grounded theoretical analysis. Results Findings highlight students’ perceptions of the transformative impact of the graduate program on their personal and professional development. This impact was reflected across three key domains: (i) personal and professional growth, (ii) takeaway learnings, (iii) application of learning in family therapy practice. Conclusion When taught within a culturally safe process, our findings show the powerful, recursive alignment of Indigenous ways of knowing and Western systemic approaches to family therapy. This integration is not only perceived as professionally enriching by students but also appears to support their personal growth and in turn their capacity to work respectfully and effectively with First Nations families. By embedding these respectful, integrated pedagogies into tertiary clinical training, students and supervisors can contribute to building sustainable practice capacity within First Nations communities, ultimately strengthening family and community wellbeing.
Black Americans have lower engagement in traditional mental health treatment compared to White Americans. However, complementary and alternative medicine is widely used, can be integrated into traditional treatment, and may have fewer barriers associated with it than traditional treatment. This study examined Black and White Americans' hypothetical willingness to engage in depression treatment options across modalities (traditional vs. alternative vs. religious vs. none) as well as factors associated with reported willingness to engage in treatment (i.e., race, symptom severity, religiosity). Participants (n = 185; 92 Black Americans, 93 White Americans) were presented with four vignettes describing varying severities of depression symptomatology and indicated their likelihood of using various treatment modalities. Repeated measures ANOVAsH indicated that as symptom severity increased, participants reported greater willingness to engage in traditional treatments. Conversely, as symptom severity decreased, participants reported greater willingness to engage in alternative treatments. Overall, participants reported greater willingness to engage in alternative treatments. Treatment willingness did not differ by race, but greater religiosity-which was higher in Black participants-was associated with greater willingness to engage in religious treatment. Further research is needed concerning other factors affecting willingness to engage in alternative treatment, as is a better understanding of when and why people are more willing to seek alternative treatment.
Self-conscious emotions, specifically shame and guilt, are pivotal factors in the onset, maintenance, and treatment of various mental health disorders. While shame involves a devalued sense of the global self and internal/external stigmatization, guilt typically pertains to specific behaviors and the desire for reparation, however it can become problematic when there are inappropriate and excessive attributions of control and responsibility. This virtual issue explores the complex roles these emotions play as both clinical symptoms and barriers within the therapeutic relationship. Through a series of diverse case studies, leading experts demonstrate how various modalities, including Metacognitive Interpersonal Therapy (MIT), Acceptance and Commitment Therapy (ACT), Mentalization-Based Therapy (MBT), Eye Movement Desensitization and Reprocessing (EMDR), Control-Mastery Theory (Control-Mastery Theory), and Compassion Focused Therapy (CFT), target these emotions. Each approach offers unique strategies, from shifting evolutionary "rank" mentalities to fostering psychological flexibility and social safeness. Collectively, these papers provide clinicians with a comprehensive framework for addressing shame and guilt to enhance therapeutic outcomes and client wellbeing.
ABSTRACT Even though Open Science practices advance the credibility and accessibility of knowledge gained through research, they are not yet as common in clinical psychology as in other subfields of psychology. This paper presents an overview of how to implement Open Science practices in clinical psychology and psychotherapy research. We will address frequently encountered challenges and present different ways to deal with sensitive topics within the specific field. We explain Open Science practices while planning a study, during data collection and preparation of a publication, and for the publication of results. Finally, we will show options for how to structure a whole research group in support of Open Science practices. With different types of actions ‐ of varying degrees of complexity and openness ‐ we can continually and ethically move toward more Open Science, which will strengthen clinical research and is therefore essential for people with lived experiences of psychological symptoms, patients, psychotherapists, and for investments in psychological treatments.
