This program is for adults who have borderline personality disorder and other complex behavior problems.

Dynamic Deconstructive Psychotherapy (DDP), a community-based treatment, is designed to help individuals identify and manage their emotions, recover from poor self-image, better understand their interpersonal experiences, and develop fulfilling relationships with others.

A randomized trial conducted by program developers demonstrated that participants in DDP experienced significant reductions in symptoms of borderline personality disorder (BPD) and depression, and these reductions were maintained 30 months from the beginning of the intervention; control group participants receiving treatment as usual (TAU) experienced only modest symptom changes. DDP participants also significantly reduced recreational drug use through 30 months, while the TAU group increased recreational drug use through 30 months. There were significant reductions in parasuicide behavior (i.e., self-harm behavior with or without suicide intent) in both groups. Results from a second study by developers indicated that participants in DDP experienced reductions in symptoms of BPD, depression, and disability over the 12 months of treatment. Finally, short-term results from a randomized trial conducted in Iran indicated that participants receiving DDP experienced significant reductions in BPD symptom severity compared to those receiving enhanced usual care.

The treatment plan for DDP is guided by a manual and progresses through the following four stages:

1. Establish and maintain a therapeutic alliance - Therapist and the patient collaboratively establish a treatment contract; therapist provides psychoeducation and empathy and, with the patient, addresses barriers that may threaten the alliance;
2. Integrate polarized and distorted thoughts about self and others - Therapist helps the patient identify emotions and understand recent interactions or maladaptive behaviors; therapist proposes alternative interpretations of the patient's and others' behaviors, which could help the patient respond to situations more suitably;
3. Accept limitations of self and others - Therapist helps the patient explore mixed feelings about treatment and recovery and challenges regression to previous levels of functioning;
4. Differentiate from therapist - Therapist provides acceptance for the patient’s feelings of anger, hurt, or disappointment and encourages the patient to connect past and present experiences.

Workshops and presentations on DDP have been delivered across the United States and in other countries since 2000.

DDP is implemented by licensed therapists (i.e., psychologists, psychiatrists, clinical social workers, and marriage and family therapists), and these therapists receive weekly supervision from an advanced DDP therapist. Required training in DDP consists of reading the manual and/or completing an online training module. Workshops and group or individual consultation are also available. Please use details in the Contact section to learn more.

Considerations for implementing this program include recruiting therapists and ensuring they receive training, acquiring participant buy-in and commitment, and finding a suitable location to hold sessions.

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

If you are interested in implementing DDP, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu

This program is implemented in weekly, 1-hour sessions for 12 to 18 months.

The primary implementation costs for delivering the DDP program consist of therapists’ salaries and salaries for the professionals who supervise the therapists.

To move the DDP program to the Effective category on the Clearinghouse Continuum of Evidence, at least one external evaluation should be conducted that demonstrates positive outcomes lasting at least one year from program completion or two years from the beginning of the program. This study must be conducted independently of the program developers.

The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu

You may also contact Dr. Robert Gregory by email gregoryr@upstate.edu or contact Upstate Medical University by mail State University of New York, Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210-2375, phone 1-315-464-5540, or visit https://www.upstate.edu/about/contact.php

https://www.upstate.edu/psych/education/residency/psychotherapy/dynamic_decon.php; https://www.sprc.org/resources-programs/dynamic-deconstructive-psychotherapy-ddp; and Gregory, DeLucia-Deranja, and Mogle (2010).