Borderline personality is the most common and serious of the personality disorders, affecting 1% of the general population.
The Clinical Practice Guideline for the Management of Borderline Personality Disorder (2012) will assist health professionals to diagnose, treat and manage BPD in adolescents and adults.
This guideline will also improve understanding and recognition of BPD in health services and the community.
Developed by a multi-disciplinary Guideline Development Committee of clinical, consumer and carer representatives with BPD expertise, the guideline discusses a range of treatment options, including 63 recommendations covering diagnosis, management, treatment and information for supporting carers and families.
These Treatment Guidelines have been developed by Project Air Strategy to assist services and practitioners working with personality disorders.
The scope of the new Guideline includes the assessment of the Borderline Personality Disorder, and the treatment and management of these together with severe mental illnesses in primary care settings:
- Health professionals providing care to women in the perinatal period (20 weeks pregnant to 4-6 weeks post-birth) should access training to improve their understanding of care for women with borderline personality disorder
- Trauma-informed care and specific support for health professionals in dealing with challenging behaviours is a priority.
- A coordinated approach should be taken with a team covering parent and infant mental health care, and access to intensive maternal child health care in the postnatal period. There should be clear communication, advance care planning, a written plan, and continuity of care across clinical settings.
- Ensure that child protection risks are understood and addressed, if necessary.
- Where possible, provide women with BPD with structured psychological therapies that are specifically designed for this condition and conducted by trained and supervised health professionals.
- Encourage pregnant or postnatal women with BPD to undertake mindfulness or relaxation training to assist in managing emotional dysregulation.
- As far as possible, don’t use pharmacological treatments as the primary therapy for women with BPD, especially during pregnancy. This is because of the risks to the fetus of some medications during pregnancy, and the risk of overdose or substance dependence for the woman of some medications.
Explore the National Institute for Health and Care Excellence guideline for assessment and management of BPD in this interactive flow chart.
Personality Disorder: The Definitive Reader
This book is excellent value for anyone who has had difficulty working with clients who have personality disorder. It brings together fourteen classic papers, which address the impact that working with personality disorder patients can have on staff. It also offers theoretical explanations for personality disorder, and explores other issues such as the concept of boundaries in clinical practice, psychiatric staff as attachment figures and the relationship between severity of personality disorder and childhood experiences. Each paper is introduced with contextual material, and is followed by a series of questions that are intended to be used as educational exercises.
Personality Disorder and Community Mental Health Teams: A Practitioner’s Guide
This book considers the various difficulties encountered, with reference to current thinking about the origins, maintenance and treatment of personality disorder. Written by practitioners for practitioners, it provides a framework for developing effective care plans with minimal use of technical terms and jargon. Rather than promote an approach based on a single theoretical model, consideration is given to ways in which different approaches can be effectively combined within a multi-disciplinary team.