Confidently Approaching Borderline Personality Disorder in Young People: A Primer for the General Child and Adolescent Psychiatrist

Objectives: Young people exhibiting traits of borderline personality disorder (BPD), including self-injury, chronic suicidality, and emotional dysregulation, present at all levels of care. Many practitioners, however, feel ill-equipped to work with this population without specialized training. This presentation will provide attendees with a knowledge base so that they feel confident working with young people with BPD traits. Attendees will gain practical tools derived from evidence-based treatments, including mentalization-based treatment for adolescents (MBT-A) and dialectical behavior therapy (DBT). They will learn how rational prescribing practices can fit into a comprehensive treatment plan and how they can help families to promote recovery. Methods: Dr. Carlene MacMillan will provide an overview of the clinical course of BPD, with an emphasis on dispelling myths about making and sharing the diagnosis with young people and their families. Dr. Owen S. Muir will explain core MBT-A techniques with minimal jargon. Tips on incorporating MBT techniques across various levels of care will be provided. Dr. Francheska Perepletchikova will discuss modifying DBT for preadolescent children with dysregulated behavior. Dr. MacMillan will provide guidelines on prescribing medications for this population. Dr. Rosa Nouvini, a physician whose sister has BPD, will share her perspective regarding family members working effectively to help their loved ones. Dr. Bruce Hassuk, who is the director of a state hospital, will facilitate a dialogue regarding the perspectives that the panelists have provided. Results: Attendees will gain practical tools that they can integrate into their practice when working with young people who are exhibiting traits of BPD. Varying perspectives will deepen attendees' understanding of this population, leading to more confidence and willingness to work with these patients and their families in clinically effective and professionally rewarding ways. Conclusions: All CAPs should be able to diagnose and manage the disorders that affect their patients, including BPD. General practitioners can have a working knowledge of how to manage this disorder by learning from the perspectives of providers who have had success in working with this population by using a variety of treatment modalities.