General Psychiatric Management for Adults with BPD

Description

This workshop offers training in a treatment approach to borderline personality disorder (BPD) known as Good or General Psychiatric Management (GPM). In a large randomized control trial comparing Dialectical Behavior Therapy (DBT) to GPM, a less intensive, structured and informed approach based on Gunderson’s Clinical Guide and APA Guidelines, no differences in any outcome was statistically significant across different outcomes such as symptomatic distress, suicidal behavior, functioning, and overall BPD pathology (McMain et al., 2009, 2012).


This generalist approach to managing this prevalent, disabling, and sometimes fatal but treatable diagnosis is good enough for most clinicians and most patients, and provides mental health professionals guidelines they need to become skilled providers who can derive satisfaction from treating patients with BPD. Management strategies using practicality, good sense, and flexibility are emphasized. Listening, validation, judicious self-disclosures, and advisement to build a life rather than focus on being a patient create a positive relationship in which both the concerns and limitations of a mental health professional are explicit. Techniques and interventions that facilitate the patient’s trust and willingness to become a proactive collaborator will be described. Guidelines for managing the common and usually most burdensome issues of managing suicidality and self-harm (e.g., intersession crises, threats as a call-for-help, excessive use of ER’s or hospitals) will be reviewed. Principles for the management of co-occurring disorders and medications from an evidence-based point of view are presented pragmatically. How and when psychiatrists can usefully integrate group, family, or other psychotherapies will be described.