Involving Significant Others in Borderline Personality Disorder Treatment
Most therapy is independent, conducted one-on-one, with the client and therapist working together. When couples are having relationship trouble they may seek couples counseling. Families may seek out family counseling to reduce interpersonal conflict and improve relationships. But, when there is one patient seeking treatment for a specific mental health issue, romantic partner involvement is usually neglected.
When someone with borderline personality disorder (BPD) seeks treatment, should romantic partners be included in treatment? BPD greatly impacts the ability to have stable, rewarding relationships. In addition, it can be very stressful for those who love someone diagnosed with BPD. It can be difficult to live with a partner who displays unpredicted shifts in mood, high levels of anger and conflict, self-harm, suicide attempts, and other risky behaviors.
There are many ways for those who love someone with BPD to get help. Persons can seek outside support and information. Persons can receive supportive therapy for themselves, ideally from a therapist experienced in treating borderline personality disorder. Or, such persons can be included in their loved one’s treatment. A recent study examined the inclusion of significant others in BPD treatment, and examined whether that lead to better outcomes for the persons with BPD.
The authors examined a number of previous studies that involved significant others in BPD treatment, including dialectical behavior therapy (DBT). One of the most promising techniques involved bringing in the client’s partners for a 2-hour training, on the CBT or DBT techniques the client was learning. This allowed the partners to better support the BPD client. For example, a partner could assist an upset client unable to remember which skill to apply… “Did you try X?”
Partner involvement is no doubt valuable, though there is a lack of systematic ways to accomplish this. Many DBT clinicians who do include significant others likely do so in an informal, case by case basis, and would likely benefit from a manualized approach.