The Case of "Sonia" Through the Lens of Dialectical Behavior Therapy

Abstract

Scherb (2014) describes the case of Sonia, a 44-year-old woman with severe and complex presentation of borderline personality disorder, along with diagnoses of bipolar disorder, trichotillomania, borderline intellectual functioning, and obesity. At the end of 10 years of therapy with decreasing frequency, Sonia has made a dramatic recovery from almost all of her presenting symptoms. Scherb's therapeutic approach was based on Fernández-Álvarez's Integrative Psychotherapy Model, which incorporates behavioral, cognitive, and emotional components. In this commentary we look at Sonia's psychopathology and treatment through the lens of Dialectical Behavior Therapy, a highly developed treatment model that has shown impressive success in treating individuals with borderline personality disorder and that also combines behavioral, cognitive, and emotional components. A comparison of a DBT approach to Sonia's case with the approach Scherb actually employed reveals many similarities in proposed treatment strategies, as well as differences in the format and delivery of treatment.