Group Therapy Proposal for Adolescent Borderline Personality Disorder

Introduction

Borderline Personality Disorder (BPD) affects both teens and adults. There is sufficient research on how this disorder affects adults, but content addressing how it affects teenagers remains limited. Teens represent a sensitive group in society — they are in the developmental phase and experience significant behavioral change. As a result, teens often become vulnerable to BPD, a situation that proves confusing to caregivers and parents. The series of changes during adolescence makes it challenging to identify actual BPD symptoms among teens, and there have been ongoing controversies about whether this particular group warrants a BPD diagnosis. However, the personality effects of BPD among teens and the extent to which those effects shape their future lives make diagnosis necessary in order to address the growing challenges.

BPD is a mental health disorder characterized by compromised relationships, irregular behaviors, varied moods, and a distorted self-image. When people suffer from BPD, controlling their moods becomes extremely difficult, and this has significant consequences for their personal lives and their interactions with others. For adolescents who have not yet fully developed, the disorder can substantially affect behavior and character formation. In addition, the effects of BPD on adolescents and the associated interventions make it challenging for therapists to design appropriate strategies to meet this population's needs (Sharp & Fonagy, 2015).

The focus of this proposal on BPD is essential because of the importance of emotional control and mood regulation. The research examines mood changes among adolescents and serves as a meaningful step toward exploring possible therapeutic interventions that can help adolescents control their moods and develop positive social relationships. To derive the best findings on BPD, the study is designed to incorporate existing research in order to identify current therapeutic approaches and to utilize past statistical data that demonstrate the prevalence of BPD among teenagers.

Rationale

Adolescents display variation in behavioral changes due to hormonal influences during the transitional phase of development. As a result, it is possible to mistake BPD symptoms for these normative changes, making a specific focus on this population necessary (Sharp & Fonagy, 2015). Focusing on adolescents as a group to examine the effects of BPD helps generate diverse data and provides a more comprehensive picture of what teenagers with BPD experience, as well as the challenges their parents face in understanding and managing their behavior. Findings are more reliable when participants come from varying social classes, locations, and environments that influence them, resulting in an outcome that more accurately represents the actual effects of BPD. This rationale also helps eliminate the bias associated with using a less integrated sample.

Literature Review

Continuous research has contributed to a better understanding of BPD. The disorder has been linked to suicide in some cases because it contributes to depression and functional impairment. While no single explanation fully accounts for the root causes of BPD, research reveals some genetic connections, with certain individuals showing higher susceptibility. Unfortunately, many people fail to seek medical attention, making the disorder more prevalent (Leichsenring et al., 2011). Research also indicates that historical reluctance to examine BPD in adolescents has been challenged by clinical records providing practitioners with valid prevalence data. Active assessment is therefore essential, and precise diagnostic methods are needed to identify and address BPD among adolescents (Sharp & Fonagy, 2015). A lack of solid research on predisposing factors affects how practitioners approach this disorder, and the recurring effects manifest in later-life difficulties — raising the fundamental question of preventive intervention.

BPD has been linked to inappropriate, uncontrolled, and intense anger (Berenson et al., 2011). Research shows that couples in which one partner has BPD record numerous instances of marital violence and amplified rates of marital dissolution. Hostility becomes uncontrollable, and intensified rage increases the likelihood of self-harm. These incidences vary from one individual to another, but one characteristic is common among people with BPD: a pervasive feeling of rejection. As a result, they withdraw from relationships, affecting their personal growth. Adolescents who experience BPD in this form grow into weak relational partners, feeling insecure and chronically stressed. Berenson et al. (2011) explain that although people with BPD exhibit extreme anger levels, those levels fluctuate across different encounters. Dialectical behavior therapy (DBT) has a positive effect on people with BPD because it incorporates multiple practices that reduce these effects — for instance, telephone coaching and skills training to reinforce positive behavior (Linehan et al., 2015).

According to Reuter et al. (2015), there is a meaningful relationship between BPD and teen dating violence. In research involving 778 adolescents, borderline features were conspicuously evident among victims of violence. The authors conclude that borderline features must be considered when addressing teen dating violence and victimization. While BPD is often considered difficult to diagnose, several symptoms are associated with it in teens. Depression is common among teens with BPD, who experience frequent mood fluctuations and react unexpectedly — shifting from happiness to extreme anger. They develop a deep fear of rejection and abandonment, causing chronic insecurity.

Consequently, teens with BPD tend to gravitate toward people they believe will provide security. However, because their feelings fluctuate, maintaining relationships becomes difficult across peer, family, and other social contexts. Teens with BPD often engage in risky and impulsive behaviors, including self-harm and suicidal behavior. They may also exhibit paranoia. It is important to note that symptoms differ from one teenager to another, but the fundamental method of assessment centers on behavioral and mental changes (Sharp & Fonagy, 2015).

For this reason, BPD diagnosis focuses on behavioral changes and the motivations behind specific behavior. For instance, a teenager who engages in substance abuse does not automatically become a candidate for BPD. However, if that teenager's substance use is primarily motivated by emotional management or avoidance, this can be a meaningful indicator of BPD. BPD can be addressed by adopting various preventive interventions. Establishing structures that minimize the possibilities of trauma exposure is one such approach. Early detection is also critical: when parents notice behavioral changes in teens, they should seek therapeutic interventions to manage the condition before it becomes destructive (Sharp & Fonagy, 2015).

References

Berenson, K. R., Downey, G., Rafaeli, E., Coifman, K. G., & Paquin, N. L. (2011). The rejection–rage contingency in borderline personality disorder. Journal of Abnormal Psychology, 120(3), 681–690. https://doi.org/10.1037/a0023335

Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2011). Borderline personality disorder. The Lancet, 377(9759), 74–84. )61422-5

Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., McDavid, J., Comtois, K. A., & Murray-Gregory, A. M. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder. JAMA Psychiatry, 72(5), 475.

Reuter, T. R., Sharp, C., Temple, J. R., & Babcock, J. C. (2015). The relation between borderline personality disorder features and teen dating violence. Psychology of Violence, 5(2), 163–173. https://doi.org/10.1037/a0037891

Sharp, C., & Fonagy, P. (2015). Practitioner review: Borderline personality disorder in adolescence — recent conceptualization, intervention, and implications for clinical practice. Journal of Child Psychology and Psychiatry, 56(12), 1266–1288.