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References
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35
Key points:
I
Individuals with personality disorder are
heavy users of health services.
I
Establishing the efficacy of psychological
therapy for personality disorders should be a
priority for clinicians and researchers.
I
Decisions about clinical care should be based
on the best available evidence.
I
Although there are few well controlled
studies, research findings suggest that people
with personality disorder can be successfully
treated using psychological therapies.
I
There is no clear evidence of the superiority
of one type of treatment approach over
another or for a particular method of service
delivery (inpatient, outpatient, day
programme).
I
Treatment benefits appear particularly
evident when treatment is intensive, long-
term, theoretically coherent, well structured
and well integrated with other services and,
where treatment has been provided in a
residential setting, follow-up care is provided.
I
The efforts made in engaging patients and
keeping them engaged in treatment, and the
quality of the therapeutic alliance achieved,
are crucial factors in determining treatment
outcome. 
I
There is a need for further research with
carefully defined populations, clearly defined
treatment goals, and long follow-up periods
incorporating cost benefit analyses.