Skip to main content
ABCT 2025 59th Annual Convention Main banner
Psychology Tools Ad
Final Program


Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Recorded Session
Recorded Session
Ticketed Session
Ticketed Session
ViewAttendees 1

Individual Oral Paper

Personality Disorders

Personality and Trait Level

2 - (IOP 17) Skillfulness Mediates the Relation Between Stronger Within-person Alliances and Session-to-session Improvements in Borderline Personality Disorder Features in BPD Compass

Saturday, November 22, 2025
3:15 PM - 3:30 PM CST
Location: Celestin A, Level 3
Keywords: Borderline Personality Disorder, Emotion Regulation, Psychotherapy Process
Recommended Readings: Fruhbauerova, M., Terrill, D. R., Semcho, S. A., Stumpp, N. E., McCann, J. P., Sauer-Zavala, S., & Southward, M. W. (2024). Skill use mediates the within-person effect of the alliance on session-to-session changes in anxiety and depression in the Unified Protocol. Journal of Mood and Anxiety Disorders, 5, 100043. https://doi.org/10.1016/j.xjmad.2023.100043,   ,   ,   ,  
Borderline personality disorder (BPD) is a severe and heterogeneous psychiatric condition. Although several efficacious treatments for BPD exist, they have typically shown moderate benefits compared to control conditions (Cristea et al., 2017). We developed BPD Compass, a modular, personality-based, 18-session individual cognitive-behavior treatment for BPD with distinct skill modules designed to target the three personality dimensions most characteristic of BPD: negative affectivity, antagonism, and disinhibition (Sauer-Zavala et al., 2023). We tested whether the skillfulness with which patients implemented the skills taught in treatment (i.e., knowledge gained; frequency, quality, and effectiveness of skill use) mediated the effect of patient-rated alliance scores on session-to-session changes in BPD features. Participants (N = 100; Mage = 28.1; 74% female; 89% white; 65% sexual minority) completed measures of past-week skillfulness and BPD features before each session and rated the strength of the alliance after each session. Within-persons, a stronger alliance predicted greater skillfulness, which predicted session-to-session reductions in BPD features, ab = –.02, SE = .01, p = .02, 95% CI [–.04, –.01]. When exploring the three subscales of the alliance, only greater within-person agreement on the tasks of therapy, and not agreement on treatment goals or the therapeutic bond, significantly predicted subsequent within-person improvements in skillfulness and reductions in BPD features, ab = –.05, SE = .02, p = .01, 95% CI [–.09, –.01]. These findings replicate previous work in the Unified Protocol and suggest that getting greater buy-in from patients in how they can use the skills taught in session may facilitate more skillful application of skills between sessions and be a mechanism of change in this treatment.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Specify how particular components of the therapeutic alliance facilitate skillful application of therapy skills between sessions to improve borderline personality disorder features.