Transference-Focused Psychotherapy (TFP) Principles for Mental Health Professionals in Higher-Acuity Settings

Clinicians working in higher-acuity settings will routinely treat patients with serious personality disorder (PD) pathology. The goal of this chapter is twofold: to introduce the utility of imparting principles of Transference-Focused Psychotherapy (TFP) to clinicians working in these settings in the Spanish mental health system, and to outline a didactic approach to imparting this matter to clinicians who may have limited familiarity with psychodynamic theories in general, and TFP’s core principles, in particular. A review of the Spanish system will highlight the familiar challenges observed in mental health systems worldwide, underscoring the specific gaps in the optimal treatment of those patients with primary or co-occurring PD diagnoses. The authors describe the ways that TFP principles derived from extended, individual outpatient psychotherapy can be learned and used by those who work in significantly different situations including the day program, emergency room (ER), and psychiatry inpatient services. Use of TFP principles in this context is proposed as an adjunctive set of skills. Application of TFP principles in the management of PD patients across the continuum of services in this particular government-supported system is offered as a template with a focus on avoiding iatrogenic complications and improving patient care.