319 – Borderline Personality Disorder and Co-occurring Disorders

Effective Treatments for Complex Clients
Melissa O’Neill

We now know that along with accompanying mood disorders, 78 percent of adults with borderline personality disorder (BPD) will develop a substance disorder or addiction at some point. Understanding and addressing this complex comorbidity can make treating these clients less overwhelming. Through experiential exercises and case studies, we’ll explore how personal biases toward clients with BPD can affect diagnosis, treatment, and outcomes, and we’ll focus on a range of evidenced-based practices for treating this complex diagnosis. You’ll discover how to:

  • Implement effective strategies for managing impulsivity in BPD clients, including mindfulness and relapse-prevention planning
  • Apply basic elements of Dual Focus Schema Therapy to treatment, such as altering clients’ negative belief systems to help break the cycle of chronic relapse
  • Utilize strategies from DBT and ACT for co-occurring disorders, including distress-tolerance skill implementation and thought diffusion
  • Cultivate awareness of personal biases to avoid common traps with BPD clients, such as blaming the client and getting caught in their narrative


Melissa O’Neill, LCSW, is the director of program development at Timberline Knolls Residential Treatment Center. She specializes in work with co-occurring disorders and BPD and is trained in DBT and ACT.

Speaker Disclosures:
Financial: Melissa O’Neill is the director of program development at Timberline Knolls.
Non-financial: Melissa O’Neill is a member of the International Association of Eating Disorder Professionals.

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