Transference focussed psychotherapy

Transference-Focused Psychotherapy-TFP- is a type of psychodynamic psychotherapy developed specifically to help patients who are experiencing difficulties as a consequence of having developed personality problems. Commonly these problems are called personality disorders and examples of those treated with TFP are borderline, emotionally unstable, and narcissistic personality disorders.

TFP is offered as a once-weekly therapy for at least a year; sessions are with an individual therapist, not in groups.

There is an evidence base for TFP with two randomised-controlled trials (research using such trials are considered to produce good evidence) showing how helpful TFP can be. One trial compared TFP with DBT and supportive psychotherapy; the other trial was a comparison of outcomes for TFP and community based psychotherapists.

In the UK there are TFP therapists is various parts of the country with therapists practicing here in GMMH. People who access TFP do report finding the therapy helpful. In fact overall patients attending for this therapy show significant improvement according to the outcome measures we currently use.

TFP aims to help people resolve their difficulties at the level of what they are experiencing within their personality. In other words we try to go beyond ‘symptom relief’ and address what underpins and drives these symptoms.

TFP is therefore a relatively intensive therapy. We have a couple of elements to our therapy that are worth thinking about if you are considering TFP. The first is we have a verbal therapy ‘contract’ with our patients. This is designed to include things the person wishes to address and change and sets down a framework in which the therapy can proceed.

The contract does also include what the patient can reasonably expect from their therapist.

A part of the, contract, the second thing that is specific to TFP is that we expect people who are attending for therapy to engage with an activity outside the home alongside therapy. This can be anything the person wants to do. If someone is already at college, working, doing voluntary work then they don’t need to take on anything else. The idea is to help people who don’t do anything outside the home to be more involved with the world. We find this has numerous benefits; people have more contact with others and can bring this to therapy; people are working towards realising their potential which is likely to lead to more positive feelings about themselves.

TFP has been developed over the past 30 years; it started around a group of therapists in New York led by Dr Otto Kernberg who is leading psychoanalyst and theorist in this field.

The reason TFP was developed was really because personality difficulties affect all areas of a person’s life; people report problems in relationships, sometimes self-harm, significant problems managing their mood, difficulties with work or any other activity where they are around people as well as difficulty containing anger and other strong emotions. The therapy is designed to offer a safe space in which all these things can be explored with the aim of both better understanding but also significant change.