How is borderline personality disorder treated?

Written from a lived and living experience perspective.

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What treatments are best for borderline personality disorder?

The most effective treatment for borderline personality disorder (BPD) is psychotherapy. Psychotherapy means talking with a qualified mental health clinician and working together to find ways to change how you feel, think and act in the world. It involves learning new strategies and skills, as well as finding ways to improve emotional wellbeing and overall quality of life.

What psychological treatments are there for BPD?

There are many forms of therapy that are effective for BPD. The treatments fit into two categories: specialist and generalist.

Specialist treatments for BPD

A specialist psychological treatment is a form of psychotherapy that is delivered by a specialist mental health clinician (such as a clinical psychologist), or by a mental health clinician who has received specialist training in a particular practice or skill. Credentialed mental health nurses, mental health endorsed occupational therapists, nurse practitioners and accredited mental health social workers are able to specialise in these treatments if they have received appropriate training.

There are several specialist psychological treatments designed specifically to help people with personality disorder. These include:

  • Dialectical Behaviour Therapy (DBT)
  • Mentalization Based Treatment (MBT)
  • Transference Focused Psychotherapy (TFP)
  • Schema Focused Therapy (SFT)
  • Cognitive Analytical Therapy (CAT)

Generalist treatments for BPD

Generalist treatments for BPD can be delivered by any therapist with experience in treating people with mental health issues. Although their effectiveness is similar, these require less training and can be offered more cost-effectively to a larger number of people. Generalist treatments include:

  • General Psychiatric Management (GPM)
  • Structured Clinical Management (SCM)
  • Integrated Modular Treatment (IMT)
  • Good Clinical Care (GCC)
  • Supportive Psychotherapy (SP)

Something important to know about these treatments for BPD is that the benefits are very similar when the treatments are compared. This is because there are 'common factors' shared by all of these evidence-based treatments that, when applied in therapeutic relationships, have a very positive impact on recovery.

What about medications?

The current evidence-based recommendations are that BPD-appropriate psychotherapy is the treatment of choice for experiences related to personality disorder. Many people are prescribed medications to help alleviate symptoms associated with other mental health conditions, however there is currently no medication that specifically treats personality disorder.