Integrating Dialectical Behavior Therapy and Prolonged Exposure to Treat Co-Occurring Borderline Personality Disorder and PTSD: Two Case Studies Original Research Article

Despite the high rate of trauma and PTSD among individuals with borderline personality disorder (BPD), no studies have specifically evaluated the treatment of PTSD in a BPD population. These case studies illustrate the use of a protocol based on prolonged exposure therapy that can be integrated into standard dialectical behavior therapy to treat co-occurring PTSD in BPD clients. Two women with BPD and chronic PTSD were treated and results indicate a significant improvement in PTSD symptoms as well as a variety of secondary outcomes. Despite having recent and extensive histories of suicidal and nonsuicidal self-injurious behavior, as well as ongoing low to moderate urges to engage in these behaviors, neither client self-injured or attempted suicide during the PTSD treatment. These preliminary findings demonstrate the potential efficacy of combining an exposure treatment for PTSD with standard DBT, while also showing that exposure-based PTSD treatments can be implemented safely and effectively with BPD clients.