Psychoeducation and Borderline Personality Disorder

For sufferers of borderline personality disorder (BPD), understanding more about their disorder may be enough to make it better. A new study found that pairing psychoeducation and borderline personality disorder patients in a group setting saw promising results. BPD patients responded well to a program of psychoeducation, a therapeutic approach that aims to help patients learn about their illnesses and the effects that the illness has on their lives. The findings could be especially beneficial for borderline personality disorder sufferers who live in communities underserved by more traditional mental health providers.

A Different Approach to Therapy

In psychoeducational group therapy programs, participants with similar diagnoses are brought together for sessions run by a leader who presents educational content about their disorder. The goal of the program is to teach participants about the effects of the disorder and help them build coping skills. The group setting surrounds participants with peers who are suffering from the same disorder, and group discussions are usually encouraged.

The advantage of psychoeducational programs is that they’re often feasible even in communities where there is a lack of traditional mental health services. Sessions are often run by mental health professionals, but they may also be led by peers or other community members. Programs are relatively short, and the group setting lowers expenses. All this can make the programs more accessible where resources are scarce.

Psychoeducation has shown to be effective in treating substance abuse. The approach has also been applied to a wide range of mental illnesses and disorders, including depression, social anxiety, and phobias.

Psychotherapy, also called talk therapy, is a fundamental treatment approach for borderline personality disorder. Your therapist may adapt the type of therapy to best meet your needs. The goals of psychotherapy are to help you:

• Focus on your current ability to function
• Learn to manage emotions that feel uncomfortable
• Reduce your impulsiveness by helping you observe feelings rather than acting on them
• Work on improving relationships by being aware of your feelings and those of others
• Learn about borderline personality disorder

Types of psychotherapy that have been found to be effective include:

• Dialectical behavior therapy (DBT) – DBT includes group and individual therapy designed specifically to treat borderline personality disorder. DBT uses a skills-based approach to teach you how to manage your emotions, tolerate distress and improve relationships.
• Schema-focused therapy – Schema-focused therapy can be done individually or in a group. It can help you identify unmet needs that have led to negative life patterns, which at some time may have been helpful for survival, but as an adult are hurtful in many areas of your life. Therapy focuses on helping you get your needs met in a healthy manner to promote positive life patterns.
• Mentalization-based therapy (MBT) – MBT is a type of talk therapy that helps you identify your own thoughts and feelings at any given moment and create an alternate perspective on the situation. MBT emphasizes thinking before reacting.
• Systems training for emotional predictability and problem-solving (STEPPS) – STEPPS is a 20-week treatment that involves working in groups that incorporate your family members, caregivers, friends or significant others into treatment. STEPPS is used in addition to other types of psychotherapy.
• Transference-focused psychotherapy (TFP) – Also called psychodynamic psychotherapy, TFP aims to help you understand your emotions and interpersonal difficulties through the developing relationship between you and your therapist. You then apply these insights to ongoing situations.
• Good psychiatric management – This treatment approach relies on case management, anchoring treatment in an expectation of work or school participation. It focuses on making sense of emotionally difficult moments by considering the interpersonal context for feelings. It may integrate medications, groups, family education and individual therapy.

 Back From the Edge – Offering guidance on the treatment of Borderline Personality Disorder from the NewYork-Presbyterian Hospital

Bipolar disorder and borderline personality disorder are complex disorders that are often interrelated and difficult to differentiate. You can watch a video from Mayo Clinic psychiatrist Brian A. Palmer, M.D., M.P.H., discusses the two disorders, the interface between them and ways to distinguish them diagnostically, by clicking here.

BPD Responds to Psychoeducation

In a new study just published in the Journal of Clinical Psychiatry, a group of Italian researchers evaluated the effectiveness of a psychoeducational program for a group of borderline personality disorder patients. The study gathered a group of 96 patients with a borderline personality disorder diagnosis, and 48 of the participants were given a six-session course of psychoeducational group therapy. The other 48 participants were put on a “waitlist” and didn’t receive the therapy. All of the participants received standard, non-intensive treatment for BPD.

Stressed with Borderline Personality Disorder: How Dialectical Behavior Therapy Helps  from MedCircle

Before the therapy began, participants were assessed on a scale that measured the severity of their borderline personality disorder characteristics. They were assessed again at the end of the therapy program, and yet again two months after the conclusion of the therapy.

The results of the study were dramatic. The participants in the psychoeducation group saw improvement in all areas of the borderline personality disorder assessment, and in most BPD traits, the improvement was greater than that in the control group. Almost half of the psychoeducation group showed substantial improvement in their borderline personality disorder traits (as defined by at least a 50% improvement in their assessment score compared to their baseline assessment). Only 6% of those in the control group showed such marked progress. The improvement remained consistent even at the two-month mark after the end of the program.

New Opportunities for Underserved Communities

The Italian study specifically targeted participants from underserved communities in an attempt to see if psychoeducation is a good alternative where traditional therapies are unavailable. The results are good news for borderline personality disorder patients who are unable to afford individual therapy or who live in places where qualified therapists are in short supply.

Suicide and Self-Harming Behaviors

Borderline personality disorder is associated with higher rates of suicide and self-harming behaviors. Patients with borderline personality disorder who are thinking of harming themselves or attempting suicide need help right away. If you or a friend or family member is experiencing suicidal thoughts or self-harming behaviors: Call the National Suicide Prevention Lifeline (NSPL) toll-free at 1–800–273–TALK (8255), 24 hours a day, 7 days a week. The service is available to everyone. The deaf and hard of hearing can contact the NSPL via TTY at 1–800–799–4889. All calls are free and confidential. Contact social media outlets directly if you are concerned about a friend’s social media updates or dial 911 in an emergency. Learn more on the NSPL’s website. Take seriously any comments about suicide or wishing to die. Even if you do not believe your family member or friend will attempt suicide, the person is clearly in distress and can benefit from your help in finding treatment. For more about suicide prevention, visit www.nimh.nih.gov (search word: suicide prevention).

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