Transference-focused psychotherapy (TFP) is a manualized evidence-based treatment for borderline and
other severe personality disorders that is based on psychoanalytic object relations theory. Similar to other
psychodynamic psychotherapies, TFP focuses on changing psychological structures, but also focuses on
symptom and behavioral change, particularly the importance of being active (e.g., obtaining a job or
involvement in similar activities). In TFP, the establishment of the treatment contract, also known as the
treatment frame, is where goals such as work and other activities are agreed upon. The focus on such
activities is particularly relevant to the concept of behavioral activation. We provide a clinical vignette
to illustrate how TFP utilizes behavioral activation in facilitating treatment outcome both at the
behavioral level and at the psychological level.