L’alliance thérapeutique avec les patients limite en thérapie cognitivo-comportementale

Abstract

This article consists in a review dealing with three main notions. It first describes the borderline personality disorder. After a short notice on the epidemiology figures and diagnosis criteria, the sub-categories proposed by Gunderson within this disorder are exposed. The etiological hypothesis of the borderline personality disorder, as well as its cognitive psychopathology, according to Beck, are also recalled. Our article then introduces Beck's cognitive behaviour therapy for borderline patients, and its effectiveness, as assessed by recent international publications. Thirdly, our review is dedicated to the therapeutic alliance. After exposing the concept of therapeutic alliance through Bordin's pantheoretical approach (relying on the notions of “goals”, “tasks” and “bond”), we examine the therapeutic alliance in borderline patients who follow a cognitive behavioural therapy. The non-compliant attitudes that borderlines tend to adopt are reviewed, as described by international literature, along with Beck's recommendations to therapists in order to trigger and maintain these patients’ collaboration throughout treatment. Then, a description of the main characteristics of the alliance in borderline patients is proposed, through a short review of publications.