Patient Views of BPD Treatments

Borderline personality disorder patients report that even good therapies have room for improvement

(RxWiki News) Psychotherapy, or talk therapy, is a common treatment for borderline personality disorder  (BPD) and reduces symptoms. New research asked for the patient perspectives about how the treatments were working.

Patients receiving psychotherapy reported that their treatment was helpful, but that the treatments seemed to focus on certain symptoms, like relationships and self-harming behavior, while neglecting their other goals. 

Treatment providers and patients can work together to create a treatment plan.

"Talk to your therapist about your treatment goals"

Researchers at the Queen Mary University in London, led by Christina Katsakou, PhD, performed a qualitative study on the perspectives of patients in treatment for BPD.

They used a structured interview process to find out how well the treatments aligned with the patient’s goals and to discover the patient perspective on recovery.

This qualitative study did not measure specific symptoms or functions. Instead, they asked patients open-ended questions and combined the information to better understand how people feel about their treatment and recovery.

Dr. Katsakou and colleagues interviewed 48 patients with BPD who were in one of two types of specialized BPD treatment or in a generalized mental health service.

They found that patients with BPD in this study had a variety of personal goals for their treatment including: improving relationships, employment, emotional control, self-acceptance, and avoiding self-harm behaviors.

Patients also reported that their BPD treatments seemed to focus on relationships and self-harm behaviors, which they felt were important. However, these patients felt that their other goals, like employment and self-acceptance, were not attended to as well by their therapy.

The authors of the study noted that the therapies address issues like self-acceptance and employment indirectly.  The more specialized BPD treatments are more likely to meet these needs than generalized therapy, but patients in all types of therapy may need more direct attention for these goals.

The patients in this study also reported that the term ‘recovery’ is misleading. They thought that their recovery was a process where they would experience gains and losses in function. 

The patients reported feeling that thinking of recovery as full remission from symptoms was not a practical or feasible goal

The researchers noted that the study is limited because all the patients were from East London and not all therapy types were represented.  

They concluded that this research is a first step towards bringing together treatment aims and patient goals.

The study was published in May in PLoS One. The authors report no financial conflicts.

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Review Date: 
May 21, 2012