Accessing Appropriate Therapy for BPD Diagnosis or Traits. 

Hi It’s true that people with a diagnosis of BPD are considered difficult to treat and many staff working in mental health still lack the knowledge and skills required to treat personality Disorder (PD) In the past once such a diagnosis was given then if the psychiatrist thought it was untreatable you would be dischrged from mental health services. This changed in 2003 with the publication by the department of health of PD no longer a diagnosis of exclusion and in the mental health act ammendments made in 2007. Since this time clients can not be excluded from mental health services based on this diagnosis. However we all have a personality and are all ‘damaged’ to varying degrees. Depending on the severity of your PD this will determine what service you receive. If you have traits this is unlikely to result in you being appropriate for the complex care treatment or community mental health teams in your area. It is only if you are appropriate for such a team that you would require a Care Co-ordinator. With regard to therapy and treatment NICE guidelines for BPD are quite clear that you should not be prescribed medication based solely on this diagnosis. Instead it recommends particularly two forms of therapy Dialectic Behaviour Therapy (DBT) or Mentalization as a rough guide on which therapy is most appropriate for you. The criteria that I use in recommending or delivering these two treatments are if you self harm then DBT (It has a stronger research base / efficacy at stopping self harm behaviour) if you have thoughts life is not worth living, difficulty with emotions etc then Mentalization. Other therapies woth considering if they are available in your area are Therapeutic Community. With people who have traits I might also recommend or deliver Mindfullness based interventions / therapy. Hope this is helpfull.