Objective: The goal of this study was to develop a sense of how borderline personality disorder (BPD) is treated in the community. The focus was on psychotherapeutic treatments.
Methods: A 13-item online questionnaire was distributed to 291 clinicians in the province of British Columbia, Canada. Participants were asked about treatment provision, their opinion of optimal treatment, and clinician confidence using both fixed and open response questions.
Results: The response rate was 43%. Of the respondents, 64% indicated that they provided treatment to patients with BPD, although two thirds of those responses indicated use of ill-defined treatment approaches. In the responses that involved what could be described as well-defined treatment approaches, dialectical behavior therapy (DBT) was the most frequently mentioned (20%). Most treatments were offered in an individual therapy format (60%); 38% described providing treatment on a long-term basis. Responses concerning optimal treatment for BPD favored DBT (45%), a combined individual-group therapy format (48%), and long-term duration of treatment (42%). Clinician confidence in treating BPD was low and there was a strong desire for further training.
Conclusion: The community mental health clinicians who were surveyed were aware of the serious nature of BPD and seek to treat the disorder. However, much of the treatment they provide does not conform to what respondents indicated they considered optimal. Clinicians who responded to the survey seemed relatively unaware of empirically supported psychodynamic treatments for BPD. There is a need for improved training and education regarding BPD and for further dissemination of information concerning empirically supported treatments for BPD.