Download PDF Borderline Personality Disorder A practical guide to treatment by Roy Krawitz

Sinopsis

Gina, a community mental health nurse, is allocated to see Anne, a client, at a routine referral meeting. Gina planned to maintain regular contact with Anne and ‘‘keep an eye on her’’ whilst Anne was on the waiting list to see one of the people ascribed skill in treating people such as Anne. Anne had been previously diagnosed as meeting diagnostic criteria for borderline personality disorder. She had been attending psychiatric services for eight years which included 20 admissions to acute psychiatric units and a similar number of visits to emergency departments as a result of self-harm. Anne self-harmed most weeks, sometimes in a manner which was like ‘‘playing Russian roulette’’.

Gina did not see herself as being especially skilful in the treatment of people meeting diagnostic criteria for borderline personality disorder but she knew she had attained professional maturity in her practice as a psychiatric nurse. She was compassionate and believed that people meeting diagnostic criteria for borderline personality disorder were deserving of treatment and could get better. Unlike many of her colleagues, she had maintained optimism and enthusiasm for her work and her clients.

Gina met Anne and together over a period of storms, crises, emergency service and acute inpatient admissions, they collaboratively developed a clinical plan including acute admission and crisis plans. Michael and Dorothy worked on the crisis and acute inpatient teams and did not see themselves as having specific expertise in this area but, like Gina, did have considerable general mental health skills. There were discussions between Gina, Michael, Dorothy and Anne with significant conflicts of views. Over the months however, they developed a coherent plan they could agree to, for the most part.

Content

1. Background to treatment
2. Treatment issues and clinical pathways
3. Stigma, language, clinician feelings, and resourcing
4. The legal environment
5. Maintaining enthusiasm

Click here to download