Factors for Effective Treatment for BPD
- Clear plan for therapy guided by an understanding of what works for BPD
- Clear limits of what the therapist can and can’t provide and when to refer to other supports as needed
- Therapy focuses on the relationship between the person and the therapist and their support network
- Providing the person and their support network eg family/friends/carers with information about the diagnosis, treatment and prognosis in a hopeful and realistic way.
- Empathy and validation of the person’s distress
- Focus on the relationship. The therapist is genuinely interested and seeks to understand what is going on for the person
- The therapist treats the person as an individual, collaborating with them and cooperating with them ie “doing with” rather than “doing to”
- Therapy focuses more on the reasons for the person’s behavior/s and actions than on the actions themselves and helps them to develop an understanding of their mind (thinking / feeling) and the link between thoughts and actions
- Exploration together of what situations leads to distress
- Assist learning of less harmful skills for managing stress
- Repair of misunderstandings between the therapist and the patient when they occur
- Develop together a collaborative management plan…..what works and when / what doesn’t work and why
Focus on empathy and validation of emotion pain when person becomes distressed
- Promote autonomy, independence and agency
- Being prepared and having a consistent responses to distress
- Encouraging trust and validation
- Recognise that the person’s experience is “real” to them. They are “doing the best they can” given their circumstances at that time
- Building and maintaining motivation. Everyone wants a better life but some people with BPD feel uncertain about change. Many find it hard to imagine how things can improve so the therapist must maintain hope for change even when the person with BPD is unable to
- The therapy also focuses on helping the person regain or maintain their interests and vocation/study and relationships.
These 'common factors' are based on the principles outlined in the NHMRC BPD Guidelines 2012.