20th Annual National Educational Alliance for Borderline Personality Disorder (NEABPD) Conference5/18/2025
20th Annual National Educational Alliance for Borderline Personality Disorder (NEABPD) ConferenceOn May 3rd, several Castlebrook clinicians attended the NEABPD annual conference held at Yale. This conference is unique in that it brings together researchers, providers, clinicians, clients, and family members to address common themes in the treatment of Borderline Personality Disorder (BPD). This year’s conference focused on the topic of access to treatment for individuals with BPD, and the supports offered to their loved ones as well.
After welcoming remarks from conference chairs, Dr. Suzanne Decker provided information to attendees about how research on psychotherapies is conducted, with the goal of educating consumers and clients about how to be selective about various treatment options being offered in the community. She discussed ways clients and their families can search for information on different treatments and how different levels of research studies, including meta-analyses (larger studies that combine a multitude of individual studies to find common outcomes), and randomized controlled trials (where participants are randomly assigned to treatment arms to compare outcomes to see if treatment is effective) are the best indicators of treatment efficacy. Additionally, she also encouraged people to explore clinicians’ training, experience, and expertise to match a client’s values, culture, and preferences. After setting this stage, Dr. Decker provided information on research done with Veterans struggling with emotion dysregulation, specifically utilizing Dialectical Behavior Therapy (DBT) and while the outcomes are positive, there are many barriers to Veterans being able to access this treatment, including staff training, the limited staff availability to provide such a complex and nuanced treatment effectively, and limited buy-in from administrators who might deem DBT to be too costly to provide. Dr. Shireen Rizvi provided the Keynote Presentation on the evidence behind the DBT Skills component of DBT treatment, and how it improves behavioral and emotional outcomes. (To read more about all of the components of DBT Treatment, read this blog post by Kerrie Toole, LICSW.) Dr. Rizvi described how her research was impacted by COVID and in wanting to support individuals seeking treatment but could not access it due to the pandemic, and how her team created videos of several DBT Skills that are accessible to the public on YouTube, and you can find them here. Dr. Rizvi also presented on barriers to accessing DBT treatment including availability of the treatment (and how there are now only 557 DBT-Linehan Board Certified Clinicians in the world), cost (as most DBT providers do not accept insurance), time (as DBT is typically a one-year treatment protocol with services 2-3 times per week, and often can take longer than this), and cultural factors (as DBT was not originally developed with cultural differences in mind). Dr. Rizvi provided research on ways to reduce these barriers, including by incorporating trainees in treatment provision, reducing the length of time in DBT treatment, and reducing the “dose” of DBT depending on a client’s severity of symptoms. A panel of providers including Dr. Jesse Finkelstein, Dr. Kiki Fehling, and representatives from Family Connections and Emotions Matter shared ways that clinicians can increase dissemination of DBT through the use of video conferencing and social media to broaden access to skillful living. Dr. Sarah Fineberg presented information on how individuals with BPD are often undertreated due to lack of appropriate and effective resources, and yet overmedicated by prescribers due to intensity of symptoms. She reviewed how to date, medications have little to no effect on BPD symptom severity, and there are no medications that are FDA approved or recommended. However, because BPD symptoms are often debilitating, clients will be prescribed a multitude of medications to address emotional dysregulation, impulsivity, depression, anxiety, and how even anti-psychotic medications are prescribed. Dr. Fineberg shared research on how people with BPD are often overprescribed medications, for example 40% of people with BPD are prescribed three or more medications, even in the absence of any other diagnosis. Dr. Fineberg presented different ways prescribers can work with patients with BPD to reduce overprescribing while still addressing symptoms and assisting them with accessing treatments. Dr. Maggie Davis presented on different treatment approaches to BPD, including traditional psychotherapy, DBT, Mentalization-Based Therapy, Schema Focused Therapy, Transference Focused Therapy, Dynamic Deconstructive Psychotherapy, Good Psychiatric Management, and Systems Training for Emotional Predictability and Problem Solving. Dr. Davis shared information on how each treatment addresses BPD symptoms, and the limitations of each. Saadia Ali, Esq., MBA and Abbey Chesley shared their lived experiences with being diagnosed with Borderline Personality Disorder, the struggles they went through, and how treatment has helped them to build skills to regulate emotions and improve relationships and sense of self. This year’s NEABPD conference provided us with inspiration on how to increase access to life changing treatments, and ways to advocate for more resources and coverage to allow us to continue to provide DBT to our community. We look forward to next year’s conference! Clinician Spotlight: An Interview With Anastasia Wilcox, MS.We are thrilled to welcome Ana Wilcox to the Castlebrook team! Ana will be starting in mid May, so we are sharing this Clinician Spotlight between Ana and Castlebrook’s Intake Coordinator, Nicole Kilian.
Nicole: Hi Ana, as one of the newest clinicians here, welcome! I’d love to hear a little bit about what helped you decide to come join the Castlebrook team? Ana: Thank you, I’m excited to be here! Kerrie was so welcoming and warm. The environment at Castlebrook seemed to fit everything I was looking for and it seemed like a community I could fit into. Nicole: That is great to hear! So, what are you looking forward to most about this position? Ana: I'm looking forward to continuing to practice my clinical skills, meeting new people, and growing as a therapist. Nicole: That’s wonderful! I know you told me a little bit about how you had mainly seen children in previous settings. I’d love to hear a little bit more about the populations that you're looking to work with here at Castlebrook. Ana: Right now, I work a lot with children experiencing anxiety, depression, and ADHD. I also see adolescents and adults with sleep disorders and tic disorders, so I guess I see a wide range of clients. Nicole: That is so interesting. I know you've been in the field for a little while now and I’d love to hear more about your niche areas if you have any. Ana: Yeah, I love working with the adolescent population. I think a very niche thing that I've been working with is the sleep disorders. I love helping people who are struggling to sleep, because the difference in a client who isn't sleeping versus is sleeping is immense and seeing that change is amazing. So, sleep disorders is definitely a niche of mine! I am also interested in CBT, DBT and EMDR therapy. Nicole: That sounds so interesting. You mentioned EMDR, is that something you’re looking into getting certified in and continuing to work with? Ana: I would like to continue to learn more about it. I'm not trained in it but the tools used in EMDR are really helpful and I implement a bit with some of my clients. Nicole: It sounds like you're really passionate about that and it’s great to hear. I was wondering how you feel that you create a safe space for your new clients. Ana: Yeah, I love to reassure my clients that this is a safe space with me and am sure to validate their feelings, thoughts, and everything that's coming out during therapy. A big thing is also normalizing experiences that are going on for them, because we are all humans, and any human that shows up and any problem they have is understandable for that person, and we're going to work through it together. Nicole: I love that because it is so important to make sure that a new client feels safe. So, I guess now I want to hear a little bit more about you. Anything that you do for fun or hobbies outside of the therapeutic setting? Ana: Yeah, I love yoga and barre. I'm a big fan of really any body movement. I also love traveling and learning new things! Nicole: Amazing! Those are all such perfect ways to unwind. Thank you for sharing that and chatting with me today. I look forward to seeing all the great work you’re going to do here at Castlebrook. Making Friends as an AdultBy Niamh Smithers, MA
Throughout childhood and adolescence, there are built in systems that help us meet and connect with others: school, organized sports, extra curricular activities… you name it! After high school, some individuals go on to higher education at colleges and universities where the options for clubs, social groups, and opportunities for connection seem somewhat endless. Regardless of the way in which you entered what I’ll refer to as “working adulthood,” I believe there is a common struggle that many people experience at one point or another when these systems start to break down... How do I make friends as an adult? So what happens when we no longer have the built in systems to help us make and maintain our relationships? As society evolves into using more and more technology, how do we stay truly connected to one another? And while, in many cases, technology has supported people being able to connect more through long distance phone calls, FaceTimes or social media, how do we continue using these tools to foster connection rather than create easy opportunities for disconnection. In other words, in the age of highlight reels, ghosting, and remote working, how and where do we find our people? Step 1: Find and Foster Your Authentic Self Understanding yourself and your experiences is a great starting place if your goal is to find connection with others. I’m sure you’ve heard the saying before, “People don’t often remember what you did, but they remember how you made them feel.” Have you ever considered how behaviors you engage in throughout the day make you feel? So often we “go through the motions” and are left feeling burnt out, numb, or disconnected from ourselves and our environments at the end of the day, which can easily translate into our relationships. While the primary message of this blog post is about connection with others, step one involves connecting with ourselves, which can be a powerful catalyst for creating and maintaining interpersonal relationships. If we are engaging with the external world in an authentic way, it can increase the chances we find other people who share similar interests or goals. Learning about and understanding our own limits, boundaries, and values can provide a great blueprint for how we want to feel about ourselves within our relationships. Next time you are spending time with other people, try noticing how your own energy, engagement, or self-perception changes (or doesn’t change) following the interaction. Step 2: Explore Likes, Dislikes, and Unknowns. If I asked you your favorite and least favorite food, you would probably be able to come up with an answer rather quickly. If I asked you to name a food you have never tried but are open to trying, that might take some more thought. When I say “explore likes, dislikes, and unknowns,” I essentially mean: stay open! To provide an example: Growing up, I never understood the desire to eat raw fish, yet I always found myself feeling like I was “missing out” when friends would get excited to get sushi. For a while, I only ate rolls that had vegetables or fully cooked fish, yet I could never say, “I don’t like sushi” as a way to explore other dining options because I had never truly tried it. One afternoon, with the support of my partner’s reassurance, I felt brave enough to try some sashimi (the rawest form of fish you could possibly order at a sushi restaurant). And let me tell you… that one brave, low-stakes leap of faith to try something I had never tried before (and was honestly a bit scared of) led me to discovering one of my favorite foods! This had a domino effect and led to me feeling more confident accompanying my friends to sushi outings, which led to me finding one of my favorite restaurants that serves excellent sushi while musicians perform live jazz (another new “like” I discovered), which in turn led to me planning more outings with my friends. All of this is to say, it is great to know what we like and don’t like. However, knowing what you like and dislike can sometimes create limitations or self-limiting beliefs. I used to believe I could never join my friends for sushi because I never ate “real sushi,” and it was those anxieties/fears and my assumed judgment from others that prevented me from exploring the unknowns. Next time you are presented with an opportunity to try something new, whether that be food, activities, or experiences, see if you notice any anxieties or fears emerge and ask yourself: would you like to live expansively or restrictively? Step 3: Explore Your Communities Now that you’ve built up an understanding of your authentic self and you’ve become open to the unknowns and potential limitations that can come with rigidly defined likes and dislikes, where do you look for your people? Let’s start with a list of general spaces to begin looking to increase your chances for meeting new people: volunteer opportunities, book clubs, local intramural sports, fitness classes, spiritual or religious groups, or hobby classes. You may be sitting there saying, “But how do I find these communities?” Some options for starting your search include: looking up your favorite coffee shop or book store to see if they host open mics or post about book clubs in the area. I often see those old-school tear off posters on bulletin boards in my local community hot spots, but I have rarely stopped to actually tear one off! When in doubt, Google is always there to help broaden your search. It may be helpful to start with a prompt such as “(insert hobby/activity) groups near (town I live in or near)”. Another way to explore your communities could be simply making an effort to do tasks you are used to finishing at home out of ease and comfort, and challenging yourself to go to a local library, cafe, or park (weather permitting!). Step 4: Maintenance As people transition further into adulthood, making plans to see friends can feel like a full-time job. Many friends move to different states, take demanding jobs, or simply don’t have the capacity to maintain friendships the way they did when those build-in-systems were in place. It can be an uncomfortable and challenging time when our friends aren’t as available as they once were, or even when we find ourselves lacking capacity to maintain our friendships the way we would like to. Key pieces of the maintenance puzzle are: being flexible, honoring limits, and communicating openly. I am intentionally putting “flexibility” and “honoring limits” next to each other because they almost contradict one another. Honoring limits does not necessarily mean being rigid and inflexible…and being flexible doesn’t necessarily mean sacrificing your own needs to maintain relationships by being overly flexible (because that can be a slippery slope!). Step 4 can sometimes be lumped into Step 1 in that, to honor your limits in interpersonal relationships, you must first understand what those limits are! After that, it’s up to you to communicate those limits to your friends. Being an adult is hard…meaningful connection to others can make it a little easier! If you’ve read this far and are still thinking, “Man…I wish there was a simpler, less wordy, less personally anecdotal way to learn about this!” you’re in luck! The mindfulness app Headspace, wrote a to-the-point article that can offer some additional ideas to support you in making connections: https://www.headspace.com/articles/make-friends-as-adult |
Archives
May 2025
Categories |
RSS Feed
Mission Statement
Castlebrook Counseling Services, Inc. is a group of private practice clinicians with a shared goal of strengthening our community by providing therapy and clinical support designed for children, adults, and families to successfully meet life’s challenges.