Objectives: This study was the first to explore how staff that work with people diagnosed with borderline personality disorder (BPD) perceive recovery in this client group. These views are important because of the crucial role that staff play in the care of people with BPD, and the challenges that staff experience with these clients.
Design: A Q methodology design was used, containing 58 statements about recovery.
Methods: Twenty-nine mental health staff sorted recovery statements according to perceived importance to recovery in BPD.
Results: There were two different viewpoints about recovery in BPD. A medically oriented group viewed coping with symptoms and behaviours specific to BPD as being most important to recovery, whereas participants who were more well-being oriented viewed achieving overall well-being that was universally valued regardless of diagnosis as more important. Both groups reported that engaging in socially valued activities such as work and education was not an important aspect of recovery and that people with BPD could be considered to have recovered despite continued impairments in everyday functioning.
Conclusions: Staff perceptions of recovery in BPD can differ, which poses risks for consistent team working, a particularly important issue in this client group due to the relational difficulties associated with the diagnosis. Multidisciplinary teams working with people diagnosed with BPD therefore need to find a forum to promote a shared understanding of each patient's needs and support plans. We advocate that team formulation is a promising approach to achieve more consistent ways of working within teams.
Practitioner Points: Findings Multidisciplinary teams working with people with borderline personality disorder should use team formulations to create a shared understanding of individual patient's needs and goals for recovery, so they can deliver a consistent approach to care. Recovery questionnaires should be used to develop an understanding of a patient's individual recovery goals. Limitations Opportunity sampling was utilized in recruitment, and the sample was not representative of the general population of staff working with borderline personality disorder. Although views from a wide range of professions were sampled in this research, the views of psychiatrists were not represented.
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http://dx.doi.org/10.1111/bjc.12180 | DOI Listing |
Neuropsychopharmacology
January 2025
Department of Gynecology and Obstetrics, Emory University, Atlanta, USA.
Borderline Personality Disorder (BPD) is characterized by rapidly shifting emotional, interpersonal, and behavioral symptoms, often co-morbid with mood and anxiety disorders. Females are more likely to be diagnosed with BPD than males and exhibit greater functional impairment. Hormonal fluctuations may influence the manifestation of BPD symptoms.
View Article and Find Full Text PDFJ Affect Disord
January 2025
Research Department of Clinical, Educational & Health Psychology, University College London, UK; Anna Freud National Centre for Children and Families, London, UK.
Background: The mentalization-based perspective of Borderline Personality Disorder (BPD) underscores fluctuating interpersonal functionality, believed to arise from suboptimal mentalization modes, including hyper- and hypomentalizing. The connection between ineffective mentalizing and specific BPD challenges remains ambiguous. Network theory offers a unique means to investigate the hypothesis that distinct yet interconnected mental challenges ('symptoms') construct 'disorders' through their continuous mutual interactions.
View Article and Find Full Text PDFJ Psychiatr Res
December 2024
Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, University of Luebeck, Luebeck, Germany.
Insomnia and nightmares are present in up to 45 % of individuals with borderline personality disorder (BPD) and can contribute to challenges with emotion regulation, low sleep quality, dream anxiety, increased arousal and self-control. Despite their prevalence, nightmares are usually not addressed in classical BPD treatment. Imagery rehearsal therapy (IRT) is considered first in line treatment for nightmares, however, there are no studies to date that investigate its effects in individuals with BPD.
View Article and Find Full Text PDFPsychol Trauma
January 2025
Gunderson Personality Disorders Institute, McLean Hospital.
Objective: Clients with relational trauma often face challenges in forming a therapeutic alliance, a primary predictor of psychotherapy outcomes. Unresolved traumatic stress can lead to a passive stance in therapy, manifested as a tendency to seek advice and approval from therapists in order to establish more predictable relational dynamics. This comes at the cost of adequately addressing their own therapeutic needs, which often leads to stagnation, treatment dropout, and frustration with the therapist.
View Article and Find Full Text PDFInt J Ment Health Nurs
February 2025
Mental Health and Wellbeing Program, Eastern Health, Box Hill, Victoria, Australia.
Brief admission has been widely used to support individuals with lived experience of borderline personality disorder (BPD) who are experiencing crisis. This study updates a previous 2014 systematic review of the effectiveness of brief admission for individuals with BPD. Following PRISMA guidelines, four databases (MEDLINE, CINAHL, PsychINFO and Cochrane library) were searched from 2011.
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