Working with borderline clients in therapy. I worked with them for a long time.
Working with borderline clients in therapy. Learn 59 Borderline Personality Disorder Questions to Ask a Client in Counseling. It does not extend to additional clinicians or practice settings, nor does purchase by an institution constitute a site license Clients who have been diagnosed with Borderline Personality Disorder or Emotional Instability Disorder may benefit from treatment using a DBT, schema therapy, or cognitive analytic therapy approach. Mar 1, 2017 · Abstract Counseling clients with borderline personality disorder requires a variety of skills and lends itself to multimodal treatments such as dialectical behavior therapy. But it may also be uniquely tested. Overview: Working with individuals diagnosed with personality disorders presents unique clinical challenges, often marked by therapy-interfering behaviors, emotional intensity, and complex interpersonal dynamics. Working with the Borderline Client Part 2 | The Therapy Show Bob Cooke 6. It's common to feel a mix of emotions as you embark on this journey, and it's Jan 7, 2025 · What is dialectical behavior therapy (DBT)? Dialectical behavior therapy (DBT) is a form of psychotherapy or “talk therapy” that can assist with managing intense feelings and emotions. Starting Therapy for BPD Taking the first step to begin therapy for Borderline Personality Disorder is a courageous decision, and I'm here to support you through this process. 62K subscribers 39 Sep 1, 2025 · Why are healthy therapeutic boundaries with clients important in therapy and mental health treatment? As a mental health care provider, you understand that boundaries are parameters an individual sets for how they prefer others to interact with them. Our entire therapy centres around me asserting boundaries, and client pushing them and reacting with emotional volatility (and hating themselves after for getting reactive, needing further reassurance I'm not angry/leaving). It is important to understand why termination of therapy might be necessary and to proceed in a way that is respectful of both parties. I'm telling you this because this is not a "boundary setting" problem. Transference-focused psychotherapy (TFP) treats BPD by concentrating on the relationship between the therapist and patient. For therapy to be effective, people must feel Countertransference is in all therapy relationships. We review the definitions of the innermost self and parts, the six attachment and six integrity needs, and we discuss the three major reasons why clients with BPD have been bruised and wounded by mental health professionals. Discover 8 therapy activities to enhance treatment and engagement. Dec 1, 2020 · Motivate your BPD clients with values-based treatment! This 16-week ACT protocol will help you get started today. Let’s consider six strategies to establish and communicate healthy boundaries with your therapy clients. CBT is an overarching umbrella of different techniques that are helpful for many individuals living with BPD symptoms. A prevalence of 1. Originally developed for borderline personality disorder, DBT is now widely used for conditions like substance use, anxiety, and depression (Linehan, 2015). These days, knowing how to terminate therapy elegantly is a core therapeutic skill. This video features a cognitive-behavioral therapy counseling role-play session in which CBT techniques are used to address relational and mood instability. Sep 25, 2025 · Before clients with borderline adaptations can deal with the root of their problems, they need more tools to work with their feelings productively and a daily structure in place that is sturdy Asking the right questions is crucial in therapy, especially for clients with BPD. Feb 24, 2025 · Explore CBT vs DBT and which therapy offers the best results for Borderline Personality Disorder treatment. May 22, 2025 · Dialectical Behavior Therapy (DBT) interventions focus on enhancing emotional regulation, mindfulness & distress tolerance skills. This license is limited to you, the individual purchaser, for personal use or for use with clients. We will examine how to effectively manage termination, foster lasting progress, and ensure a safe and supportive May 24, 2024 · This worksheet will help the therapist assess the history of the client with the complaints of borderline personality disorder. The stigma attached to borderline personality disorder can make both clients and counselors resistant to treatment, but by working together, they can sort through these misconceptions and help clients rediscover themselves. Gerard Fromm, PhD, ABPP answers the question: When it comes to borderline patients, what are the challenges for the therapist and the staff? The approach, called dialectical behavior therapy (DBT), provides a clear framework for treating borderline personality disorder that takes into account clients’ need for validation and self-coping skills and therapists’ need for boundaries in relationships with clients. 1. Terminating therapy with a borderline client (ending therapy with a borderline client) can be difficult for both the therapist and the client. Learn nine effective strategies for supporting someone with Borderline Personality Disorder (BPD). Along with traditional treatment, self-help strategies can help individuals manage their symptoms of BPD. Fortunately, enhanced diagnostic criteria and training are helping to equip clinicians with the necessary tools to effectively assist patients. It will also help the clients reflect on their past and how the past has shaped their thoughts and feelings. Supporting those with BPD requires us to find a balance between empathy and boundary setting. 6% makes it more common than Schizophrenia or Bipolar Disorder, and, sadly, it has been highly stigmatized both by the non-clinician and us Key principles for working with people with personality disorders “People with borderline personality disorder should not be excluded from any health or social care service because of their diagnosis or because they have self-harmed. May 1, 2025 · Cognitive behavioral therapy for borderline personality disorder helps people change the way they think about experiences by reframing negative thought patterns with positive actions. This article delves into the complexities of this therapeutic process, exploring the strategies, ethical considerations, and potential pitfalls involved. You may find yourself riding waves of intense emotion, conflict, and confusion, yet wanting deeply to help your loved one feel seen, heard, and safe. Learn how to create an evidence-based DBT treatment plan for your clients in counseling sessions. See our example DBT treatment plan. By focusing on emotional awareness, managing triggers, and nervous system regulation, these worksheets provide actionable steps to Therapists working with clients diagnosed with BPD must possess a deep understanding of the disorder's manifestations and the unique ways it can influence the client's perception of the therapeutic relationship and the very idea of ending therapy. What is going around in circles bringing up for you, and how will you manage that without bringing it into session? So I work with adults with SMI, but I specialized in bipolar disorder and psychosis in school. Key Takeaways about Supporting Someone with Borderline Personality Disorder Borderline personality disorder causes emotional instability because people with BPD have an unstable sense of self. However, it’s more common working with folks who have borderline tendencies, I had a patient who had a distinct plan to hurt/kill me. The term “dialectical” implies that two opposing things can be true at the same time. Free Therapy Aid shares worksheets, videos, guides, and other tools to aid mental health professionals in the course of their Mentalization-based therapy: interventions Bateman and Fonagy believe the crux of the therapy is client’s experience of therapist having “their mind in mind” This is more important than any specific content of interpretations or the non-specific common factors. Free Borderline Personality Disorder (BPD) worksheets for therapists to download. May 18, 2018 · Rodis has been meeting with Leila, going over the 10 Commandments of Working with Clients with Borderline Personality Disorder, the principles, the techniques, the Do’s and Don’ts of working with this patient population. And in this current article, I am going to outline, from the clinician’s perspective, 3 reasons why for acquiring the skills for working with patients and clients suffering from Borderline Personality Disorder. They challenge us with an urgency that helps us to define ourselves as we work The power differential between staff and patients, the common pejorative bias against borderline patients, the tendency for hospital staff to join together in managing the patient, and milieu reinforcement of compliant and passive behaviors run counter to DBT’s collaborative therapy relationship, non-pejorative emphasis, preference for Mentalization-based therapy: interventions Bateman and Fonagy believe the crux of the therapy is client’s experience of therapist having “their mind in mind” This is more important than any specific content of interpretations or the non-specific common factors. This draining propensity is rather common; it adds to negative countertransference and leads to clinician resistance to working with these patients and clients. For many novice counselors, the cause of professional burnout is based on factors related to quality guidance and supervision. In this workbook, Fox lucidly integrates evidence-based techniques and tools to help with thoughts, emotions, behaviors, and relationships—treating those with borderline personality as whole people who can achieve and maintain success and recovery. For a lot of clients who've encountered unhelpful therapist, there's an internalized tendency to blame ourselves. Discover practical tips that can help improve relationships and promote healing. Using the session-by-session, 16-week protocol in this professional guide, you can help clients work through the main driver behind BPD—experiential avoidance—and gain the psychological flexibility Ending therapy with a borderline client presents a unique set of challenges and considerations for mental health professionals. When a deeply troubled client begins a first session by shifting erratically through different mood states and periodically going numb, many therapists recognize—with a certain sense of dread—that they may be working with a borderline client. What are you working with her on? How do you conceptualise the nature of her difficulties? What's your diagnosis of her? Are you trained to treat those sorts of patients? If not, that's ok, but you'll need to make a choice. Acceptance and Commitment Therapy for Borderline Personality Disorder provides a comprehensive program for delivering ACT to clients with BPD. If you’re feeling fatigued, it may be a good idea to seek supervision around managing countertransference. I have a client with a BPD diagnosis, how can that present itself? Individuals with a diagnosis of Borderline Personality Disorder (BPD) may experience difficulties in their relationships with themselves and others. When it comes to helping clients with ‘borderline’ presentations, our capacity to contain and make sense of their underlying state of mind is vital. 57K subscribers Subscribed Oct 3, 2025 · Support clients with borderline personality disorder using effective strategies. It is critical that you establish the following ground rules from the start to maintain consistency and client expectations. Transference refers to feelings a patient has towards their therapist. Over the decades, a variety of psychological interventions for borderline personality disorder (BPD) have been developed. Oct 1, 2024 · Learn strategies for ethically navigating therapy termination with borderline clients, addressing challenges and ensuring best practices for a positive outcome. When terminating with a client who has a history of threatening to file licensing board complaints. I like to think of my work as providing someone space to play with their feelings. For these new skills to be most effec7ve, clients need to prac7ce them regularly – between therapy sessions. Use these BPD worksheets and exercises with your patients as session work or homework. By using social skills training, occupational therapy practitioners can optimize the social functioning of individuals with borderline personality disorder by enhancing specific skills, such as identifying and mending problems in social relationships, daily life, work and leisure (Lauriello, Bustillo, & Keith, 1999). I review the seven tenets of Therapist-Focused Consultation May 5, 2025 · Dialectical behavior therapy (DBT) is a structured, evidence-based approach designed to help individuals regulate emotions, build healthier relationships, and develop effective coping skills. The worksheet may be used by individuals working with a therapist or as part of a self-help program. ") Sep 9, 2021 · Working with the Borderline Client - Part 1 | The Therapy Show Bob Cooke 6. The premise of this therapy is rooted in the concept of “mentalizing. While therapy is the frontline approach for those with BPD, providers may prescribe medications to treat co-occurring conditions. Apr 1, 2025 · Borderline personality disorder (BPD) is a common but often misunderstood condition, even by seasoned mental health professionals. By aiming for a nonjudgmental stance, you will be better able to provide more effective care, help the Jun 10, 2011 · My insights about working with borderline personality disorder -- with clients as well as managing the volatile and difficult man who lives inside me. May 27, 2025 · This blog post explores evidence-based strategies for addressing BPD and boundaries in clinical practice, offering practical guidance for therapists working with clients diagnosed with Borderline Personality Disorder. Given the fear of abandonment often present in BPD, therapists may witness anger or frustration when they announce the end of a therapy session, even though this ending involves a normal, time-limited separation. If we are aware that the individual tends to live in constant emotional pain that distorts their perception of reality, we can learn to use empathy to increase our tolerance. Jul 4, 2025 · Borderline personality disorder (BPD) is a type of personality disorder. Either refer her out or seek supervision from a specialist. This paper provides clear and concise guidelines for conducting treatment geared toward the clinician’s developmental level Jan 19, 2024 · If you are working in a clinical setting with clients who are living with BPD, or you find yourself wanting to learn more about borderline personality disorder and effective treatment approaches, we encourage you to look for continuing education opportunities in your area. The problem I am facing is one of the clients has borderline personality disorder and smokes PCP. 1st half audio dictation of 7 Tips for Working with Clients with Personality Disorder by Bill Eddy 2nd half audio dictation: 7 Tips for Working with Clients with Borderline Personality Disorder ary suspiciousness, inappropriately intense excitement, misplaced loving feelings, etc. (Like from what I've seen with therapy clients who've had bad experiences, it seems extremely common to go "It works if you do the work, so if this isn't helping me, it must mean I'm doing something wrong somehow. Apr 16, 2024 · Are there any unresolved issues or topics from therapy that you feel require further exploration or closure before concluding our sessions? We hope that our therapy session questions for Borderline Personality Disorder (BPD) therapy will help you to elevate your therapy practice and guide your clients to inner healing! Novice counselors working with clients diagnosed with Borderline Personality Disorder (BPD) are at risk for professional burnout. And while dialectical Resources for clients Find links below to fact sheets, work sheets, videos, guides and others tools to provide to people with BPD diagnosis or symptoms. These feelings are informed by the patient’s relationships Summary In this episode we explore in detail how Internal Family Systems can help with borderline dynamics. As you know, clients with borderline personality disorder (BPD) and emotion dysregulation often struggle with negative beliefs about themselves—beliefs that can lead to feelings of shame, problems with personal relationships, and dangerous behaviors. This means you can learn to accept your behavior as part of your life experience, but also make positive changes to Sep 12, 2011 · The Rogerian tradition suggests more than simply an intellectual pursuit in the practice of person-centered therapy (PCT); it suggests a way of being in the presence of a client, family, or group. The impulsivity characteristic in Borderlines can make working with them feel considerably more challenging for the clinician. I worked with the client last year (when we had proper staffing) and had no problems in the group session as the group at the time was good about ignoring her outbursts. Apr 19, 2022 · Dialectical behavior therapy (DBT) is a type of talk therapy for people who experience emotions very intensely, including those with borderline personality disorder. Mar 4, 2025 · Mental health professionals who have clients with borderline personality disorder (BPD) can also experience unique challenges. ) Generally, treatment involves one to two sessions a week with a mental health counselor. Use contracts and informed Study with Quizlet and memorize flashcards containing terms like How can supervision and consultation benefit clinicians working with individuals who have borderline personality disorder?, How does Transference-Focused Psychotherapy (TFP) help individuals with borderline personality disorder?, What is the primary goal of Dialectical Behavior Therapy (DBT) when treating individuals with Marsha Linehan's Cognitive Behavioral Therapy for Borderline Personality Disorder changed the way I view BPD and it inspired me to work on a consultation team for a few years. May 11, 2018 · We described three reasons why, from the perspective of the patient and client (see above cited article for details). Jan 22, 2025 · Borderline Personality Disorder A New Approach May Benefit People With Borderline Personality Mentalization-based therapy is a fresh perspective on borderline personality. A client with borderline or narcissistic traits can enter treatment with a "fix me" demand, but never comprehends the need and importance for an interactive experience within a process that must allow for the gradual growth of trust. Ending therapy with a borderline client presents a unique set of challenges and considerations for mental health professionals. Apr 16, 2024 · Elevate Your Therapy and Guide Your Clients to Inner Healing with Our Borderline Personality Disorder (BPD) Validating Therapy Statements! 1. Therapists, despite being trained to maintain a professional demeanor, face unique challenges when working with clients diagnosed with BPD. Jun 30, 2025 · Mentalization-Based Therapy is an evidence-based treatment created for people with borderline personality disorder, but it can be utilized with other mental health issues. Ahead of an online training in June, psychoanalytic psychotherapist and former psychiatric nurse Marcus Evans outlines key features of working with BPD, including managing projections, the danger of Jul 28, 2025 · People living with borderline personality disorder (BPD) often struggle with self-image, emotional stability, and relationships with others. ), as the accompanying article by Shehrina Rooney d Jul 30, 2024 · Get effective therapy for Borderline Personality Disorder (BPD) and achieve long-term improvement by overcoming challenges with tailored approaches like DBT, Schema Therapy, and more. I have Borderline clients, but I’m not super experienced with treating the illness. This only adds to the suffering of those How to Write a Borderline Personality Disorder Treatment Plan (With Examples) Developing a treatment plan for Borderline personality disorder (BPD) is essential for both the therapist and the client, offering a structured roadmap to navigate the often unpredictable therapeutic process. This approach is considered a gold standard of therapy for many conditions, including BPD. Jun 8, 2021 · I supervised Anne, a therapist who was working with Sally, a client diagnosed with BPD. I’m a therapist who works often with Cluster B PDs, but by far the most frequently with BPD. You've set them and she's continually The Importance of DBT Homework Evidence-based therapies like DBT teach clients new cogni7ve, emo7onal, behavioral, and social skills to combat paXerns of nega7ve thinking and behavior. This collection of worksheets is designed to offer tools and strategies that help you navigate the unique challenges of BPD. Nov 7, 2012 · The enraged outbursts therapists often encounter when working with people who suffer from the symptoms of borderline personality disorder may involve the projection of unwanted shame and a sense of inner defect into the therapist. With these new strategies, one can go from unknowingly or unintentionally doing harm to guiding one’s patients and clients towards full recovery that they Apr 30, 2018 · Borderline personality disorder is a prevalent psychopathology; thus, most graduate students in psychology, residents in psychiatry, and early career clinicians will encounter patients with this disorder in the course of their training or initial professional practice. The client (played be an actress) has Jul 9, 2007 · Clients who are diagnosed with Borderline Personality Disorder are likely to engage with clinicians in compelling ways. Talk therapy is usually the first choice of treatment (unlike some other illnesses where medication is often first. It doesn’t have to be dreadful, according to Dick Schwartz, originator of the Internal Family Systems model. The publisher grants to individual purchasers of DBT Skills Training Handouts and Worksheets, Second Edition, nonassignable permission to reproduce these materials. Therapists who specialize in working with these clients recommended the following books for clinicians, clients and family members. She tends to lay very very hard boundaries with very Dr. (To be clear, I’m a caseworker. Working with borderline personality clients in private practice can be highly rewarding but requires managing challenges, such as boundaries, effectively. Psychotherapy Psychotherapy is most effective BPD treatment and it is essential that the patient trusts their therapist and that the relationship is a good ‘fit’. Some of these resources are focused on BPD, whereas some are non-specified to people living with a mental illness. While it can be difficult to be in a relationship with a BPD loved one, May 15, 2018 · A lack of purpose and direction in treatment has been one of the factors contributing to feeling drained when working with patients and clients suffering from Borderline Personality Disorder. I also have had several close friends and family diagnosed with the same. Jul 17, 2025 · The thoughtful communication of boundaries can also convey the therapist’s commitment to act in the client’s best interest and assurance that they will not intentionally harm the client (Barnett, 2017). Clinicians who have received training and are providing treatment for people with a BPD diagnosis may utilise a range of these different approaches. Sep 6, 2017 · Do you know the things you should do or the things you should say to someone with borderline personality disorder (BPD)? If not, join the millions of family, friends, and/or coworkers who don’t When a suicidal client is sitting across from you, how do you assess risk, negotiate no-harm agreements, and manage borderline reactivity while keeping your seat? In these riveting live demonstrations with DBT originator Marsha Linehan, learn essential strategies for working with distressed clients. DBT effectively supports individuals with borderline personality disorder & those experiencing intense emotional responses. This review updates and replaces an earlier review (Stoffers‐Winterling 2012). All these re-learning therapies require multi-year commitment and engagement In this second podcast concerning borderline process, Bob Cooke and Jacci Jones elaborate more and continue from discussion of an earlier podcast concerning the borderline position and how to work with the borderline to effect positive change. Dec 6, 2018 · This article describes how the core principles and techniques of transference-focused psychotherapy (TFP) can be used in general psychiatry to help in the management of patients with borderline personality disorder (or other moderate to severe personality disorders). Integrating DBT techniques can improve coping strategies & promote emotional wellbeing in daily life. It’s very important to me that my clients feel (and are) accurately understood and seen, and I wanted to check in with this community to see how y’all feel about my current understanding of BPD, and how people might Dec 20, 2022 · Borderline personality disorder (BPD) treatment typically includes a heavy emphasis on psychotherapy, such as DBT or CBT. treatment-interfering personality features of borderline personality disorder itself. To assess the beneficial and harmful effects of psychological therapies for people with BPD. TherapyByPro is a trusted resource for mental health professionals I love working with clients with borderline personality disorder because I find this type of work energizing. It provides clarity, safety, and direction, fostering a shared understanding of goals and strategies to BPD Worksheets Living with Borderline Personality Disorder (BPD) can feel overwhelming, especially when intense emotions and triggers arise. M. Here, we explain more about BPD, symptoms, and how therapy can help. It focuses on: knowledge – appreciating how an understanding of object relations assists the clinician in assessment and Hi. I’m not doing therapy) I have a coworker who has specialized in borderline PD and I just don’t understand her approach. Mar 27, 2022 · Many individuals seeking treatment for symptoms of borderline personality disorder (BPD) find that many therapists are reluctant to treat this condition. Like so many borderline clients, she’d been sexually abused as a child—in her case, by a neighbor. I recently began work with a 42-year-old client named Colette, who’d been in and out of several treatment centers for an unresolved eating disorder and diagnosed by the last two centers with borderline personality disorder. We noticed that every time Anne highlighted Sally’s role in a problematic interpersonal situation, Sally started to yell at Anne. I worked with them for a long time. Childhood trauma combines with biological and social factors to create this personality disorder. We will examine how to effectively manage termination, foster lasting progress, and ensure a safe and supportive . ” May 1, 2025 · Helping someone with borderline personality disorder (BPD) can be both deeply meaningful and incredibly challenging. In my clinical work with adolescents and adults What to look for in a therapist for borderline personality disorder? Because BPD is a complex disorder and patients make many demands on the relationship between therapist and client, it is Aug 1, 2025 · The Borderline Personality Disorder worksheet is often used in therapy, particularly in Dialectical Behavior Therapy (DBT), which focuses on teaching skills to help individuals with BPD manage their emotions and behaviors effectively. This 3-hour webinar offers a practical framework for recognizing and treating clients with Narcissistic, Borderline, and Antisocial Personality Disorders. Everything I do or say is 'wrong' and I'm constantly nitpicked, yet client is terrified I'll terminate. Feb 14, 2025 · Her work has involved helping clients navigate complex mental health concerns, including depression, anxiety, bipolar disorder, borderline personality disorder, and trauma. ” – NICE, 2009. In fact, Dick suggests that our Advocacy & Support for Borderline Personality Disorder & Complex Trauma Strategies for clinicians working with someone with BPD Download as a pdf May 8, 2018 · Characterized by a long-term pattern of an unstable sense of self, unstable relationships with others, and profound difficulties with self-regulation, Borderline Personality Disorder is the most common of the ten personality disorders. Ongoing management If you are in a position in which you may work with a person with BPD, it is important to remember that intention and outcome are often unrelated. Discover 50 insightful boundary-setting questions to help clients explore and establish healthy boundaries in therapy. 1 Working with Clients with Borderline Personality Disorder: How to Recognize BPD and Respond to Your Most Complex Clients LEARNING OBJECTIVES: • Recognize BPD and distingui the ndrome from other mental health di rder • Understand the long-term cour of BPD and progno ic feature which affect treatment outcome. For patients with axis I conditions and coexisting borderline traits who do not meet full criteria for borderline personality disorder, it may be sufficient to focus treatment on the axis I conditions alone, although the therapy should be monitored and the Treatments for Borderline Personality Disorder Current research shows that treatment can decrease the symptoms and suffering of people with BPD. While you may routinely help clients set boundaries at work or with their family, remember that setting boundaries and expectations (especially However, counselors can use techniques from DBT, cognitive behavioral therapy (CBT) and Rogerian skills when serving pre-borderline clients or any adolescents who present with behaviors found in a BPD diagnosis. mceq mk7 azhbt v0tuw nxtn 8oltqym rkujs rtvm1 s21zi5 zzcve