- Briefly describe the personality disorder you selected, including the DSM-5-TR diagnostic criteria.
- Explain a therapeutic approach and a modality you might use to treat a client presenting with this disorder. Explain why you selected the approach and modality, justifying their appropriateness.
- Next, briefly explain what a therapeutic relationship is in psychiatry. Explain how you would share your diagnosis of this disorder with the client in order to avoid damaging the therapeutic relationship. Compare the differences in how you would share your diagnosis with an individual, a family, and in a group session.
Support your response with specific examples from this week’s Learning Resources and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly.
Personality Disorder: Borderline Personality Disorder (BPD)
DSM-5 Diagnostic Criteria for Borderline Personality Disorder: A pervasive pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- Frantic efforts to avoid real or imagined abandonment.
- A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
- Identity disturbance: markedly and persistently unstable self-image or sense of self.
- Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
- Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
- Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety).
- Chronic feelings of emptiness.
- Inappropriate, intense anger or difficulty controlling anger.
- Transient, stress-related paranoid ideation or severe dissociative symptoms.
Therapeutic Approach and Modality for BPD: Dialectical Behavior Therapy (DBT) is a widely accepted therapeutic approach for treating Borderline Personality Disorder. DBT combines cognitive-behavioral techniques with mindfulness and validation strategies. This approach helps clients manage intense emotions, improve interpersonal skills, and develop distress tolerance strategies. Individual therapy is a common modality within DBT, focusing on addressing specific issues in a one-on-one setting. The combination of skill-building, emotional regulation, and validation in DBT aligns well with the challenges faced by individuals with BPD.
Therapeutic Relationship in Psychiatry: A therapeutic relationship in psychiatry refers to the collaborative and trusting bond between a mental health professional and their client. It provides a safe space for the client to express their feelings, thoughts, and concerns while working towards therapeutic goals. This relationship is based on empathy, active listening, and non-judgmental support, enabling effective communication and facilitating healing.
Sharing the Diagnosis: When sharing a BPD diagnosis with a client to avoid damaging the therapeutic relationship, it’s important to approach the conversation with empathy and understanding. Highlight the positive aspect of gaining insight into their struggles and developing effective coping strategies. For an individual, you might focus on their personal journey and strengths. For a family, you could educate them about BPD and its challenges, emphasizing that it’s a treatable condition. In a group session, the focus could be on normalizing experiences and fostering a sense of belonging among peers facing similar challenge