Therapy Tips Working with BPD

Working collaboratively with someone with Borderline Personality Disorder (BPD) requires creative and empathetic thinking from health professionals. However, by implementing the following strategies, health professionals can enhance their therapeutic alliance with individuals with BPD and improve their clinical outcomes.

  1. Work from hope, and empathy, and put our goals first.
    It is essential to approach therapy from a place of hope, empathy, and putting our goals first. This approach can foster a sense of trust and safety, which is crucial for individuals with BPD, who struggle with mistrust and fear of abandonment.
  2. See us as a person and not just as another person with BPD on your caseload
    It is essential to see individuals with BPD as unique individuals with strengths and capabilities, rather than just another person with BPD on your caseload. By acknowledging our strengths, uniqueness, and the fight to live, we can build a positive therapeutic alliance.
  3. Understand we don’t trust very easily, so take the time to get to know us
    Individuals with BPD have trust issues, and it may take some time to establish trust. It is essential to take the time to get to know us and understand our needs and concerns.
  4. Share- share a part of yourself
    Sharing a part of yourself can help individuals with BPD build trust and enhance the therapeutic alliance. It is essential to maintain appropriate boundaries while sharing a part of yourself.
  5. Set very clear boundaries
    Setting clear boundaries is crucial for individuals with BPD, who may struggle with impulsivity and emotional dysregulation. Setting boundaries can provide a sense of safety and structure and enhance the therapeutic alliance.
  6. Take time to understand the narrative
    It is essential to take the time to understand the narrative and history of individuals with BPD. This understanding can help health professionals tailor treatment approaches and enhance clinical outcomes.
  7. Do not judge us if we take a backward turn.
    It is all part of the journey Individuals with BPD may struggle with setbacks and relapses. It is crucial not to judge but instead provide support and understanding.
  8. Share stories of how you have utilized particular skills in your life
    Sharing stories of how you have utilized particular skills in your life can help individuals with BPD feel less alone and more understood. It can also provide them with coping strategies to manage their symptoms.
  9. Model appropriate social interactions in your own life – be authentic
    Modeling appropriate social interactions can help individuals with BPD learn and develop social skills. It is crucial to be authentic and genuine while modelling social interactions.
  10. Incorporate spirituality into mental health care
    Incorporating spirituality into mental health care can help individuals with BPD cope with their symptoms and find meaning and purpose in their lives. It is essential to ask if they have a particular source of faith and respect their beliefs.
  11. Be authentic –
    Do not say you will do something and then you don’t It is crucial to maintain authenticity and follow through with promises made. This can help build trust and enhance the therapeutic alliance.
  12. Understanding when and when not is not a good time to talk with us
    Individuals with BPD may have specific sensitivity and these present at times of the day increasing our vulnerable. It is essential to understand these triggers and times and adjust therapy sessions accordingly.
  13. Therapy is excruciatingly tiring
    Therapy can be exhausting for individuals with BPD, who may struggle with emotional dysregulation and impulsivity. It is crucial to acknowledge the efforts made and provide support and validation.
  14. Do not talk too much!
    We easily get overwhelmed. If you want us to remember something, give us that information in a written form as well. Individuals with BPD may get overwhelmed by too much information. It is crucial to present information

Thanks for reading!

Want to know more about BPD? See our ‘Understanding BPD Webinar’.
If you would like supervision or support for working with BPD or complex trauma please contact us
ottraumatools@gmail.com

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Published by OT Trauma Tools

Founder Mental health Advocate; Phd Candidate; Occupational Therapy Teacher and Researcher Australia “As an occupational therapist diagnosed with BPD I will use this page to share about the various interventions and strategies that are helpful to those with BPD. I will also share about the positive and sometimes challenging approaches that health professionals have used in my treatment in emergency, inpatient, outpatient and community settings. I hope that by sharing my lived experience I can help improve the experience of those struggling to understand Borderline Personality Disorders (BPD) and also support those living with BPD and other mental health challenges Most importantly we will share how occupation can powerfully help change lives!" Laura

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