Treating Couples with Borderline Personality Disorder, Suicidality, Self-Harm, and Emotion Dysregulation

Drs. Skye Fitzpatrick, C.Psych, Rachel Liebman, C.Psych and Candice Monson, C.Psych have spent the last several years developing, refining, and testing Sage – a treatment for couples where one member has borderline personality disorder (BPD), experiences suicidal or self-injurious thoughts and behaviours, or emotion dysregulation.

What is Sage?

Sage is a 12-session treatment that integrates principles of Dialectical Behaviour Therapy (DBT) and Cognitive Behavioural Conjoint Therapy (CBCT). Its unique focus targets three domains simultaneously:

·        BPD symptoms and emotion dysregulation

·        Relationship functioning

·        Partner mental health

To our knowledge, Sage is the only couple intervention designed to treat BPD/emotion dysregulation that has been formally manualized and tested. Pilot results are showing promising effects (Read more here, here, and here) and a large-scale RCT is currently underway.

What will I learn?

In this 2-day workshop, Drs. Fitzpatrick and Liebman will introduce Sage and offer clinicians a collection of strategies to reduce BPD, suicidality, and relationship distress. Through a mix of lecture, case material, and audience role plays, workshop participants will learn:

1. Couple case formulation of processes that maintain BPD and suicidality

2. Dyadic strategies to manage safety, regulate emotions, and interrupt life-threatening behavior and high-intensity conflict

3. Techniques to facilitate interpersonal emotion regulation and effective communication.

4. Strategies to address destructive intrapersonal (e.g., self-harm) and interpersonal (e.g., conflict) behaviours.

5. Adapted interventions for couples with a range of backgrounds and relationship structures.

By the end of the workshop, you will leave with concrete skills to disrupt harmful cycles, enhance emotional communication, and promote long-term gains in couples impacted by BPD and emotion dysregulation.

Who should attend:

Clinicians with experience in either couple/family therapy or the treatment of BPD/emotion dysregulation. (Expertise in both is helpful but not required.)

Skill level: Intermediate–Advanced

Learning Objectives:

1)    Identify couples who are appropriate candidates for Sage.

2)    Learn how to co-create appropriate treatment goals with couples.

3)    Understand the current empirical and theoretical evidence for incorporating partners into BPD treatment.

4)    Develop and deliver couple case formulation.

5)    Apply strategies to for risk assessment, safety planning and conflict management.

6)    Utilize strategies to promote interpersonal emotion regulation and effective communication.

8)    Reduce problematic interpersonal contingencies that sustain suicidal/self harm

9)    Build skills to navigate challenges to implementing Sage such as therapeutic ruptures and client adherence.

10)  Apply techniques to promote intrapersonal and interpersonal safety, dyadic emotion regulation, and sustained treatment gains.

11)  Identify and target dyadic emotional avoidance in couples.

12)  Apply strategies for targeting beliefs that maintain emotion dysregulation processes in couples  

Your Trainers:

Dr. Rachel Liebman is a developer of Sage and an expert clinician, trainer, and consultant in the treatment of couples with high conflict.  She is Adjunct Faculty in the Psychology program at Toronto Metropolitan University and the Founder and Director of Liebman Psychology, which provides specialized care for individuals and couples with problems related to emotion dysregulation and trauma. She has published 50+ peer-reviewed articles on effective treatments for trauma, eating disorders and BPD.

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Dr. Skye Fitzpatrick is a developer of Sage and an expert in the development, testing, and provision of couple treatments for BPD and emotion dysregulation. She is an Associate Professor at York University and Director of the TULiP Lab which conducts research on interpersonal processes involved in BPD and emotion dysregulation. She has published over 100 peer-reviewed articles and trains internationally on these topics.