The mechanisms of change in the treatment of borderline personality disorder with transference focused psychotherapy

Kenneth N. Levy, John F. Clarkin, Frank E. Yeomans, Lori N. Scott, Rachel H. Wasserman, Otto F. Kernberg

Research output: Contribution to journalReview article

152 Scopus citations


We address how Transference Focused Psychotherapy (TFP) conceptualizes mechanisms in the cause and maintenance of borderline personality disorder (BPD) as well as change mechanisms both within the patient and in terms of specific therapists' interventions that engender patient change. Mechanisms of change at the level of the patient involve the integration of polarized representations of self and others; mechanisms of change at the level of the therapist's interventions include the structured treatment approach and the use of clarification, confrontation, and "transference" interpretations in the here and now of the therapeutic relationship. In addition, we briefly review evidence from our group regarding the following hypothesized mechanisms of change: contract setting, integration of representations, and changes in reflective functioning (RF) and affect regulation.

Original languageEnglish (US)
Pages (from-to)481-501
Number of pages21
JournalJournal of clinical psychology
Issue number4
StatePublished - Apr 1 2006


All Science Journal Classification (ASJC) codes

  • Arts and Humanities (miscellaneous)
  • Clinical Psychology

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