Metacognitive Training for Borderline Personality Disorder (B-MCT) is derived from our Metacognitive Training for Psychosis (MCT). B-MCT is a low-threshold add-on group intervention for evidence-based standard treatments (e.g., dialectical behavioral therapy) that specifically targets cognitive biases. Pilot studies confirm its efficacy (see, for example, Schilling, Moritz, Köther, & Nagel, 2015).

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What is Metacognitive Training – Borderline (B-MCT)

Borderline personality disorder (BPD) is characterized by suddenly arising states of intense emotional arousal that are often followed by self-harming behavior or dissociative phenomena. Along with the cardinal symptom of affect dysregulation, BPD may also manifest as self-esteem instability, problems with social interaction, and behavioral disorders (especially self-harm) as well as deficits in cognitive functioning such as dissociative symptoms and dysfunctional information-processing patterns. Dysfunctional thinking styles (e.g., an altered attributional style) may play an important role in the development and maintenance of BPD symptoms. In prior studies, we have confirmed that individuals with BPD have cognitive distortions concerning, for example, social cognition and attributional style (for a more detailed presentation of our findings, see the manual and the reference list below).

To improve therapeutic options, we focus on some of the recently identified BPD-specific dysfunctional thinking styles (e.g., overconfidence in emotion recognition) as well as already well-examined cognitive biases (e.g., dichotomous thinking). B-MCT, an add-on concept that is derived from cognitive behavioral therapy (CBT), was developed by our team. Based on our own preliminary studies (e.g., Moritz et al., 2011; Schilling et al., 2012) and numerous studies in the field of basic cognitive research, we adjusted the training units from MCT for schizophrenia and MCT for depression to address the disorder-specific dysfunctional thought patterns of BPD patients. We also added new examples, with the help of our patients.

B-MCT is a low-threshold add-on intervention for evidence-based standard treatments (especially dialectical behavior therapy, DBT) that specifically targets cognitive biases. The aim of this low-threshold CBT-oriented group intervention is to raise patients’ awareness of their dysfunctional thinking patterns and help them reduce cognitive distortions.

A preliminary study has demonstrated the acceptance and effectiveness of the training. The evaluation clearly showed a large beneficial effect on symptoms as measured by the Borderline Symptom List (BSL-23). The patients were also given the opportunity to provide suggestions for improvement.

Recently, a controlled randomized study with the modified B-MCT was carried out, and this study confirmed its efficacy (in comparison with a group using relaxation strategies). An article describing these findings is in preparation.

Principle Investigators

  • Dipl.-Psych. Lisa Schilling (Asklepios Medical Center Hamburg)
  • Dipl.-Psych. Julia Bierbrodt
  • Katharina Kolbeck (M.Sc. Psychology)
  • Prof. Dr. Steffen Moritz

Co-Investigators (alphabetical order)

  • PD Dr. Matthias Nagel
  • Dr. Andreas Schindler
  • Prof. Dr. Carsten Spitzer

 Suggested Donation

The training remains available at no cost for students and researchers. However, we are now asking practitioners/psychotherapists who use the training for a one-time contribution of 30€ (or $30) to download the materials (these include hundreds of slides and a manual as well as worksheets). If MCT+ is used in an institution, such as a psychiatric hospital, we ask the institution to send us a one-time contribution of 100€ (or $100).
All contributions are considered donations, and we would be happy to send you a receipt for your donation (please send an email to Steffen Moritz (moritz@uke.de) and include your mailing address).You can transfer the funds online here.

References

Moritz, S., Schilling, L., Wingenfeld, K., Köther, U., Wittekind, C., Terfehr, K., & Spitzer, C. (2011). Psychotic-like cognitive biases in borderline personality disorder. Journal of Behavior Therapy and Experimental Psychiatry, 42, 349-354.

Schilling, L., Köther, U. Nagel, M., Agorastos, A., & Moritz, S. (2013). Kognitive Verzerrungen bei Patienten mit einer Borderline-Persönlichkeitsstörung und deren Behandlung durch das “Metakognitive Training - Borderline” [Cognitive distortions in patients with borderline personality disorder and their treatment through Metacognitive Training for Borderline Personality Disorder]. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 61, 239-246.

Schilling, L., Moritz, S., Köther, U., & Nagel, M. (2015). Preliminary results on acceptance, feasibility, and subjective efficacy of the add-on group intervention Metacognitive Training for Borderline Patients. Journal of Cognitive Psychotherapy, 29, 153-164.

Schilling, L., Moritz, S., Schneider, B., Bierbrodt, J., & Nagel, M. (2015). Attributional ‘tunnel vision’ in patients with borderline personality disorder. Journal of Personality Disorders, 29, 839-846.

Schilling, L., Wingenfeld, K., Spitzer, C., Nagel, M., & Moritz, S. (2013). False memories and memory confidence in borderline patients. Journal of Behavior Therapy and Experimental Psychiatry, 44, 376-380.

Schilling, L., Wingenfeld, K., Löwe, B., Moritz, S., Terfehr, K., Köther, U., & Spitzer, C. (2012). Normal mind-reading capacity but higher response confidence in borderline personality disorder patients. Psychiatry and Clinical Neurosciences, 66, 322-327.

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