Navigating Intersession Contact

Abstract

Common challenges posed by intersession contact with BPD patients include their propensity to become overly dependent on therapists and ensuring problematic behavioral patterns that develop to maintain increased intersession support. Yet, intersession contact can help facilitate effective treatment under certain conditions, usually when parameters for its use are clearly framed at the onset of treatment and maintained thereafter. Therapists electing to be available between sessions should do so judiciously, keep contact brief and goal directed, re-evaluate over time whether intersession contact is promoting or hindering self-reliance, and predict increased dependency on such contact during times of acute difficulty. Patients benefit from having a coherent rationale for intersession contact parameters presented within psychoeducation about BPD-related interpersonal vulnerabilities. Patients helped by these interventions to become more independent may still revert to problematic use of intersession contact, and therapists should maintain consistent expectations for intersession contact even during these more challenging times. At all stages of treatment, patients benefit from being reminded of the overarching treatment goal of achieving greater self-reliance and from sensing their clinicians believe in their capacities to do so.