Although borderlines are notoriousl

Although borderlines are notoriously difficult to work with, they are also more amenable to change than many other personality-disordered individuals. The central, initial goal is to build sufficient rapport so that work can begin on stabilizing their erratic behavior and affect. This might involve a reality-oriented approach emphasizing aspects such as limit setting, sympathy, reassurance, advice, and insight regarding internal processes. Borderlines are capable of such a wide range of dysfunctional behaviors that knowing which one to address can sometimes be confusing. In addition, they are an unusually het- erogeneous group. For example, depression, anxiety, depersonalization, disorganized thoughts, fears of abandonment, self-destructiveness, and/or ambivalence may all be- come areas requiring attention. More than for most other client groups, building a strong therapeutic alliance is crucial in helping borderlines to adjust and cope with their many conflicted forms of acting and feeling. Because many borderlines resist authority- directed interventions, group therapy might be indicated because they are more likely to be responsive to peer influence.