Anthony Bateman & Roy Krawitz (2013), Borderline personality disorder – an evidence-based guide for generalist mental health professionals

Summary. The purpose of this project was to study negative attitudes exhibited by mental health professionals toward patients with Borderline Personality Disorder (BPD) as a function of their work area (general health vs. mental health), profession, the quantity of patients with BPD they have treated over the past year, their number of years of experience in mental health, and their gender. The study used a sample of 310 professionals. We also explored how the professionals’ interest in using an innovative technological application (Medtep DBT) interacted with some of these variables, as well as the potential of the application to help change negative attitudes. Significant differences in attitude were found based on work area, profession, quantity of patients with BPD treated over the past and gender. Furthermore, profession, number of patients and years of experience in mental health determined significant differences in the professionals’ degree of interest in using Medtep DBT. Moreover, those with higher negative attitudes showed less interest in the application and a lesser willingness to try it. These results highlight the need to keep investigating how to improve the attitudes of healthcare professionals, especially nursing staff and family doctors, since they appear to be more susceptible to the development of negative attitudes. As a conclusion, we infer that the lack of empathy towards patients with BPD, the difficulties in their treatment and the years of experience in mental health all act as barriers to the implementation of the application. Resum. L’objectiu d’aquest estudi ha estat investigar les actituds negatives de professionals de la salut mental envers pacients amb Trastorn Límit de la Personalitat (TLP) en funció de la seva àrea de treball, la seva professió, pacients amb TLP tractats al darrer any, anys d’experiència en salut mental i sexe en una mostra de 310 professionals. A més a més s’han explorat, en base a part d’aquestes mateixes variables, el seu interès a usar una aplicació tecnològica innovadora (Medtep DBT) per al tractament d’aquests pacients així com la possibilitat que aquesta servís per a reduir les possibles actituds negatives. S’han trobat diferències significatives en les actituds en funció de l’àrea de treball, la professió, el nombre de pacients amb TLP tractats el darrer any i el sexe. La professió, el nombre de pacients i els anys d’experiència en salut mental també han determinat diferències significatives quant a l’interès a usar Medtep DBT. Aquells professionals amb majors actituds negatives han mostrat un menor interès i una menor disposició a utilitzar l’aplicació. Aquests resultats demostren la necessitat de seguir investigant com millorar les actituds d’aquests professionals, especialment dels d’infermeria i dels metges de capçalera, en ser els més vulnerables a desenvolupar-les. Com a conclusió es poden assenyalar la falta d’empatia envers pacients amb TLP, les dificultats en el seu tractament i els anys d’experiència en salut mental com a barreres en la implementació de l’aplicació.

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Attitudes of Mental Health Staff Toward Patients With Borderline Personality Disorder: An Italian Cross-Sectional Multisite Study

Journal of Personality Disorders ◽

10.1521/pedi_2019_33_421 ◽

2019 ◽

pp. 1-16 ◽

Cited By ~ 1

Author(s):

Mariangela Lanfredi ◽

Maria Elena Ridolfi ◽

Giorgia Occhialini ◽

Laura Pedrini ◽

Clarissa Ferrari ◽

...

Keyword(s):

Mental Health ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Social Workers ◽

Mental Health Professionals ◽

Borderline Personality ◽

Social Health ◽

Health Staff ◽

Health Educators ◽

Mental Health Staff

Negative attitudes toward borderline personality disorder (BPD) can present a barrier to those seeking care. We explored caring attitudes toward BPD among 860 mental health professionals, including psychiatrists, psychologists, social health educators, nurses, and social workers. The results showed that social workers and nurses scored significantly lower on caring attitudes than psychiatrists, social health educators, and psychologists. Our analysis showed that the more BPD patients treated in the past year, more years of experience in mental health, and having prior BPD training were positively associated with caring attitudes scores. For all professional subgroups, except for social health educators, the caring attitudes score is higher in those who have had prior BPD training, and for professionals with low and medium level of experience in mental health. This result shows that training on BPD should target less experienced clinicians and those professional groups who had less opportunity to receive such education.

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Therapeutic interventions in Australian primary care, youth mental health settings for young people with Borderline Personality Disorder or borderline traits

10.21203/rs.3.rs-27756/v2 ◽

2020 ◽

Author(s):

Nikki O’Dwyer ◽

Debra Rickwood ◽

Dean Buckmaster ◽

Clare Watsford

Keyword(s):

Mental Health ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Young People ◽

Youth Mental Health ◽

Borderline Personality ◽

Therapeutic Interventions ◽

First Episode ◽

Evidence Based ◽

Data Set

Abstract Background This study aimed to investigate what therapeutic interventions were being applied by clinicians working with young people with a diagnosis of Borderline Personality Disorder or borderline traits in Australian primary mental health care settings. Given the current lack of evidence-based guidelines for treatment with this client population, investigating what is being implemented is needed. The study also aimed to determine whether the interventions clinicians are using are effective in reducing distress and increasing functioning for these clients. Methods Participant data came from the national minimum data set for headspace youth mental health centers across Australia. Young people’s data were included in the study if the young person was diagnosed with Borderline Personality Disorder or borderline traits during their first episode of care (N=701). Clinician data that indicated the type of intervention used at each client session and outcome measures routinely captured were analyzed to determine interventions used and outcomes achieved. Results Results demonstrated that CBT was the most frequently used modality of intervention followed by supportive counselling and IPT, but that most clients received a variety of intervention types. There were no or only weak relationships between changes in outcomes and the amount of any type of intervention that was provided. No significant relationship was found with the amount of CBT a client received and changes in symptoms or functioning, despite being the most commonly employed modality. Conclusions The study highlights the need for evidence-based treatment guidelines for early intervention in young people with borderline personality disorder traits.

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Ten-week Intensive Group Program (IGP) for borderline personality disorder: making the case for more accessible and affordable psychotherapy

Evidence-Based Mental Health ◽

10.1136/ebmental-2020-300195 ◽

2021 ◽

pp. ebmental-2020-300195

Author(s):

Dervila Gec ◽

Jillian Helen Broadbear ◽

David Bourton ◽

Sathya Rao

Keyword(s):

Mental Health ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Symptom Severity ◽

Integrated Treatment ◽

Borderline Personality ◽

Self Report ◽

Evidence Based ◽

Short Term ◽

Intensive Group

BackgroundThe availability of specialist psychotherapies for treating borderline personality disorder (BPD) is limited by costs associated with training, resourcing and treatment duration. Developing a programme that incorporates effective strategies from a range of evidence-based specialist treatments, concentrates their delivery and uses a group-based format will improve treatment access.ObjectiveTo assess the short-term clinical efficacy, acceptability and feasibility of a bespoke manualised programme for the treatment of BPD. This 10-week group-based outpatient programme was delivered 2 days per week in 4 hour sessions; participants received 80 hours of treatment in total.MethodsForty-three participants, many having severe BPD symptomatology, were assessed before and after the 10-week programme using a range of validated self-report questionnaires and a self-appraisal feedback form. The primary outcome measured was BPD symptom severity.FindingsStatistically significant improvements were measured in BPD symptom severity, depression, trait anxiety, emotional regulation, general health, hopefulness, self-compassion and anger, several with moderate to large effect sizes. Many of these improvements remained at 4–6 months post treatment. More than 90% of surveyed participants expressed a moderate or high level of satisfaction with the programme.ConclusionsThis integrated treatment programme delivered in a highly concentrated format demonstrated short-term efficacy across many BPD-relevant endpoints; its acceptability was endorsed by most clients.Clinical implicationsIncorporation of key aspects of evidence-based treatment using a time-intensive group format could greatly enhance the capacity of mental health services to meet the needs of people who experience BPD within a population-based mental health service framework.

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Therapeutic interventions in primary care, youth mental health settings for young people with Borderline Personality Disorder or borderline traits

10.21203/rs.3.rs-27756/v1 ◽

2020 ◽

Author(s):

Nikki O’Dwyer ◽

Debra Rickwood ◽

Dean Buckmaster ◽

Clare Watsford

Keyword(s):

Mental Health ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Young People ◽

Youth Mental Health ◽

Borderline Personality ◽

Therapeutic Interventions ◽

Evidence Based ◽

Data Set ◽

Evidence Based Guidelines

Abstract Background This study aimed to investigate what therapeutic interventions are currently being applied by clinicians working with young people who have a diagnosis of Borderline Personality Disorder or borderline traits. Given the current lack of evidence-based guidelines with this client population, investigating what is occurring currently is needed. The study also aimed to determine whether the interventions clinicians are using are effective in reducing distress and increasing functioning with these clients. Methods Participant data came from the national minimum data set for headspace youth mental health centres across Australia. Young people’s data were included in the study if the young person was diagnosed with Borderline Personality Disorder or borderline traits during their first episode of care (N=701). Clinician data that indicated the sort of intervention used at each client session and outcome measures routinely captured were analysed to determine interventions used and outcomes achieved. Results Results demonstrated that CBT was the most frequently used modality of intervention followed by supportive counselling and IPT. There were no or only weak relationships between changes in outcomes and the amount of any type of intervention that was provided. No significant relationship was found with the amount of CBT a client received and changes in symptoms or functioning, despite being the most commonly employed modality. Conclusions The study highlights the need for evidence-based guidelines for early intervention in young people with borderline personality disorder.

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Therapeutic interventions in Australian primary care, youth mental health settings for young people with borderline personality disorder or borderline traits

Borderline Personality Disorder and Emotion Dysregulation ◽

10.1186/s40479-020-00138-2 ◽

2020 ◽

Vol 7 (1) ◽

Author(s):

Nikki O’Dwyer ◽

Debra Rickwood ◽

Dean Buckmaster ◽

Clare Watsford

Keyword(s):

Mental Health ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Young People ◽

Youth Mental Health ◽

Borderline Personality ◽

Therapeutic Interventions ◽

First Episode ◽

Evidence Based ◽

Data Set

Abstract Background This study aimed to investigate what therapeutic interventions were being applied by clinicians working with young people with a diagnosis of Borderline Personality Disorder or borderline traits in Australian primary mental health care settings. Given the current lack of evidence-based guidelines for treatment with this client population, investigating what is being implemented is needed. The study also aimed to determine whether the interventions clinicians are using are effective in reducing distress and increasing functioning for these clients. Methods Participant data came from the national minimum data set for headspace youth mental health centers across Australia. Young people’s data were included in the study if the young person was diagnosed with Borderline Personality Disorder or borderline traits during their first episode of care (N = 701). Clinician data that indicated the type of intervention used at each client session and outcome measures routinely captured were analyzed to determine interventions used and outcomes achieved. Results Results demonstrated that CBT was the most frequently used modality of intervention followed by supportive counselling and IPT, but that most clients received a variety of intervention types. There were no or only weak relationships between changes in outcomes and the amount of any type of intervention that was provided. No significant relationship was found with the amount of CBT a client received and changes in symptoms or functioning, despite being the most commonly employed modality. Conclusions The study highlights the need for evidence-based treatment guidelines for early intervention in young people with borderline personality disorder traits.

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