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We identified three phases to treatment. First, alliance formation and normalization appeared as mechanisms, and the client experienced dependence. Second, working alliance and countertransference appeared as mechanisms, and the client experienced reduced gambling and suicidal ideation. Third, external controls and increased opportunity appeared as mechanisms, and \u201cmoving into the world\u201d was the client experience. The findings give preliminary support to a phase-based constructivist treatment including trauma assessment to normalize self-feelings, countertransference work to support motivation for restraint, and case management principles to support continuity of change efforts.<\/jats:p>","DOI":"10.1177\/1049732315618659","type":"journal-article","created":{"date-parts":[[2015,12,23]],"date-time":"2015-12-23T20:19:25Z","timestamp":1450901965000},"page":"236-248","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Constructivist Simultaneous Treatment of Borderline Personality Disorder, Trauma, and Addiction Comorbidity"],"prefix":"10.1177","volume":"27","author":[{"given":"Ayna B.","family":"Johansen","sequence":"first","affiliation":[{"name":"Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway"},{"name":"Centre for Study of Mind in Nature, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shedeh","family":"Tavakoli","sequence":"additional","affiliation":[{"name":"Northeastern Illinois University, Chicago, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingerid","family":"Bjelland","sequence":"additional","affiliation":[{"name":"Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Lumley","sequence":"additional","affiliation":[{"name":"Wayne State University, Detroit, Miami, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,7,11]]},"reference":[{"key":"bibr1-1049732315618659","volume-title":"Frequent gamblers and problem gamblers in New Zealand: Report on the phase two of the national survey","author":"Abbott M.","year":"1992"},{"key":"bibr2-1049732315618659","doi-asserted-by":"publisher","DOI":"10.1521\/pedi.2012.26.4.498"},{"key":"bibr3-1049732315618659","doi-asserted-by":"publisher","DOI":"10.1075\/ni.17.2.03adl"},{"key":"bibr4-1049732315618659","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-8525.1994.tb00404.x"},{"key":"bibr5-1049732315618659","doi-asserted-by":"publisher","DOI":"10.1037\/12325-000"},{"key":"bibr6-1049732315618659","doi-asserted-by":"publisher","DOI":"10.1080\/10550490802545141"},{"key":"bibr7-1049732315618659","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2005.05.013"},{"key":"bibr8-1049732315618659","doi-asserted-by":"publisher","DOI":"10.1097\/00131746-200503000-00002"},{"key":"bibr9-1049732315618659","first-page":"195","volume":"6","author":"Berger R.","year":"2006","journal-title":"Journal of Critical Psychology, Counseling and Psychotherapy"},{"key":"bibr10-1049732315618659","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579405050443"},{"key":"bibr11-1049732315618659","doi-asserted-by":"publisher","DOI":"10.1037\/11752-000"},{"key":"bibr12-1049732315618659","volume-title":"Posttraumatic growth in clinical practice","author":"Calhoun L. 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