Key principles for working with people with personality disorders

teddy bears on couch

“People with borderline personality disorder should not be excluded from any health or social care service because of their diagnosis or because they have self-harmed.” NICE, 2009.

  • Be compassionate
  • Demonstrate empathy
  • Listen to the person’s current experience
  • Validate the person’s current emotional state
  • Take the person’s experience seriously, noting verbal and non-verbal communications
  • Maintain a non-judgemental approach
  • Stay calm
  • Remain respectful
  • Remain caring
  • Engage in open communication
  • Be human and be prepared to acknowledge both the serious and funny side of life where appropriate
  • Foster trust to allow strong emotions to be freely expressed
  • Be clear, consistent, and reliable
  • Remember aspects of challenging behaviours have survival value given past experiences
  • Convey encouragement and hope about their capacity for change while validating their current emotional experience

Extracted from Project Air Strategy for Personality Disorders Treatment Guidelines For Personality Disorders (2015).

MARY ZANARINI – Ineffective use of language

JOHN GUNDERSON – The effectiveness of basic support

VALERIE PORR – Increasing trust: A safe place to practice

For more interview footage about being a better service provider for people affected by BPD see Borderliner Notes

BENÉ BROWN – Empathy

Extra resources

See the National Health and Medical Research Council (Australia) Clinical Practice Guideline for Management of Borderline Personality Disorder (2012) for assistance in diagnosing, treating and managing BPD in adolescents and adults.

View Project Air Strategy treatment guidelines and intervention manuals.

Download this one-page fact sheet as quick guidance Recommendations for treatment of patients with Borderline Personality Disorder and Substance Use Disorder within the primary care setting

For a more comprehensive guide, read Understanding and Treating Borderline Personality Disorder.

Download Meeting the challenge – Making a difference a practitioner guide offering information, advice and guidance for those working with people with personality difficulties in community settings. The guide, commissioned by the UK Department of Health, brings together up to date thinking about personality disorder with practical advice to support staff and organisations working across health and social care services.