
        Interpersonal Group Therapy for Borderline Personality Disorder
                                       
   Beginning in 1988, Marziali and Monroe-Blum began publishing about the
   efficacy of time-limited group psychotherapy for people with severe
   personality disorders. In 1994, they published a book fully describing
   this model of psychotherapy, Interpersonal Group Psychotherapy for
   Borderline Personality Disorder.
   
   Although on the surface IPG seems to share many elements with
   Linehan's (1993) [1]DBT, the two treatment methodologies are extremely
   different. Marziali and Munroe-Blum's therapists don't take a
   didactic, teaching approach at all; they revert more to a Rogerian,
   client-centered facilitation style. Group disagreements and
   disappointments with the therapists or other group members are worked
   out within the group by clients, with the therapists intervening only
   when the process of therapy seems to be getting off-track
   ("derailing").
   
   Marziali and Munroe-Blum identify four possible subjective reactions
   experienced by therapists when dealing with BPD patients in crisis:
     * Withdrawal
     * Rejection
     * Rescue
     * Acceptance and tolerance.
       
   They argue that only the last of these will lead to a positive outcome
   for both client and therapist. "According to IGP, therapeutic
   derailment occurs when the therapist fails to process adequately the
   patient's negative projections." (Marziali and Munroe-Blum, 1994).
   This leads to the client perpetuating previous negative behavioral
   patterns.
   
   Therapist interventions in IGP are intended to be tentative,
   exploratory, indirect, and neutral. Two-sided commentary,
   reiteration/paraphrasing, reflecting doubt/confusion, answering of
   enquiries, and supportive statements are part of the IPG model.
   
   The time-limited nature of the therapy, explain Marziali and
   Munroe-Blum, assures group members of "a predictable, safe, time
   structure. This factor has particular therapeutic value in treating
   BPD, they claim, because these clients have had "repeated experiences
   with unpredictable, unsafe interpersonal encounters in which the
   testing of boundaries frequently led to rupture. . . . the patients
   benefit from other forms of group structure, such as the invariability
   of the meeting time and place, the fixed duration of each session, and
   the dependability of the therapists.
   
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References

   1. file://localhost/usr/home/llama/Web/psych/dbt.html
   2. file://localhost/usr/home/llama/Web/psych/injury.html
