The recent article by Giesen-Bloo and colleagues1 comparing schema-focused and transference-focused psychotherapy for borderline personality disorder is remarkable on 2 accounts. First, it gives hope to psychotherapists that sustaining a positive clinical relationship with patients with borderline personality disorder over 3 years of twice-weekly therapy is both possible and worthwhile. Second, it is one of the very few studies that show differential effectiveness between 2 therapy types, given that research from the past 30 years has consistently failed to find differential effects between treatment types.2 In contrast, research has shown that the therapeutic alliance,3 therapist effectiveness,4 and researcher allegiance5 powerfully relate to clinical changes. In this context, it is surprising that Giesen-Bloo and colleagues do not address these issues in their article. Such data might help readers to understand their findings, including the puzzling but large difference in dropout rates between treatments, and understand the allegiance-boosting effect that allowing patient-therapist contact between therapy sessions might have had in the schema-focused group.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Psychiatry editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 2
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.