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 includes a focus on the relationship between the person and the therapist and their support network.
Providing the person and their support network (e.g. 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 co-operating with them (i.e. ‘doing with’ rather than ‘doing to’).
Therapy focuses more on the reasons for the person’s behaviour/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.
Therapy assists with learning of less harmful skills for managing stress.
Repair of misunderstandings between the therapist and the patient when they occur.
Develop a collaborative management plan together — what works and when, and what doesn’t work and why.
Focus on empathy and validation of emotional pain when person becomes distressed.
Promote autonomy and reduce dependence.
Being prepared, and having a consistent response 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, vocation/study, and relationships.