Using Transference-focused Psychotherapy (TFP) Principles in a Family Intervention for Adolescents with Personality Disorders

This chapter illustrates a model of family therapy intervention that applies the principles of transference-focused psychotherapy (TFP) for improving parental functions in the family (TFP-PF). This intervention is indicated for a group of adolescents with severe personality pathology who show a limited appreciation of their difficulties. They present marked identity diffusion and impairment in their family, academic, and social functioning. According to Kernberg’s diagnostic classification, this group of patients would be included within the medium or low level of borderline personality organization (BPO). These adolescent patients are often referred to treatment by their adult relatives. However, adherence to individual treatment without a personal motivation to do so is often impossible in this population or leads to premature drop out early in treatment. This combination of personality pathology severity and adherence difficulties makes individual outpatient treatment unfeasible in most cases. The TFP-PF approach focuses on the resolution of certain active dysfunctional family ties that maintain or aggravate the pathological organization of the adolescents’ personalities. This family intervention initiates a process of differentiation and individuation that improves the global functioning of adolescent patients and of the relationships between them and their parents. Thus, TFP-PF promotes the adolescents’ awareness of their own difficulties, and increases adherence to individual treatment, thereby expediting its progress, and, ultimately, fostering recovery.