TFP–E is a contemporary psychodynamic, object relations theory-based approach to treating personality pathology across the range of severity (from neurotic level of personality organization through severe personality disorders). Derived from TFP and based on TFP principles, TFP-E is a goal-oriented psychodynamic therapy with the objective of improving self and interpersonal functioning in individuals with psychological difficulties across the range of severity. TFP–E builds on the convergence between a psychodynamic, object relations theory based, model of personality pathology and empirical developments in the study of personality disorders and reflected in the Alternative Model for Personality Disorders in the DSM5. Both models emphasize the centrality of self and interpersonal functioning in personality health and pathology, and improvement in these domains of functioning emerges as a central goal in treatment. As a transdiagnostic longer-term, flexible treatment model, TFP–E is built on general clinical objectives and core principles and techniques that define the treatment approach, while specifying how techniques are modified to tailor treatment to the individual patient.
TFP-E represents a modification of conventional models of analytic psychotherapy with an eye towards making use of evidence-based principles and techniques and optimizing outcome. Core elements of the TFP-E treatment model include: 1) thorough assessment and sharing one’s diagnostic impressions with the patient as a prelude to treatment, 2) establishing a treatment frame and treatment goals while understanding their functions in clinical process and outcome, 3) utilizing a systematic approach to identifying a focus of intervention, 4) managing and utilizing transference and countertransference developments in patients at different levels of severity of pathology, 5) maintaining a dual focus on clinical process and external reality, 6) reconceptualizing traditional approaches to the interpretive process, 7) offering clinicians an integrated model of mechanisms of change in psychodynamic treatments focusing on reflective processes, character analysis, and structural change.
Core Text:
Caligor E, Kernberg OF, Clarkin JF, Yeomans FE: Psychodynamic Therapy for Personality Pathology: Treating Self and Interpersonal Functioning. Washington, D.C., American Psychiatric Press, 2018