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Perspectives of crisis intervention for people diagnosed with 'borderline personality disorder': an integrative review.

Warrender, Dan; Bain, Heather; Murray, Ian; Kennedy, Catriona

Authors

Dan Warrender d.r.warrender2@rgu.ac.uk

Heather Bain heather.bain@rgu.ac.uk

Ian Murray i.d.murray@rgu.ac.uk



Abstract

Introduction: 'Borderline personality disorder' ('BPD') is associated with frequent use of crisis intervention services. However, no robust evidence base supports specific interventions, and people's experiences are not well understood. Aim: To explore the experiences of stakeholders involved in the crisis care of people diagnosed with 'BPD.' Method: Integrative review with nine databases searched January 2000 to November 2017. The search filtered 3,169 titles and abstracts with 46 full-text articles appraised and included. Results: Four themes were constructed from thematic analysis: crisis as a recurrent multidimensional cycle, variations and dynamics impacting on crisis intervention, impact of interpersonal dynamics and communication on crisis, and balancing decision making and responsibility in managing crisis. Discussion: Crisis is a multidimensional subjective experience, which also contributes to distress for family carers and professionals. Crisis interventions had limited and subjective benefit. They are influenced by accessibility of services, different understandings of 'BPD' and human dynamics in complex decision-making, and can be experienced as helpful or harmful. Implications for practice: Subjectivity of crisis experiences shows limitations of the diagnostic model of 'BPD,' emphasizing that interventions should remain person centred. While thresholds for intervention are often met after self-harm or suicidality, professionals should review approaches to care and support people with underlying distress.

Journal Article Type Review
Journal Journal of psychiatric and mental health nursing
Print ISSN 1351-0126
Electronic ISSN 1365-2850
Publisher Wiley Open Access
Peer Reviewed Peer Reviewed
Institution Citation WARRENDER, D., BAIN, H., MURRAY, I. and KENNEDY, C. [2020]. Perspectives of crisis intervention for people diagnosed with 'borderline personality disorder': an integrative review. Journal of psychiatric and mental health nursing [online], EarlyView. Available from: https://doi.org/10.1111/jpm.12637
DOI https://doi.org/10.1111/jpm.12637
Keywords Borderline personality disorder; Emotionally unstable personality disorder; Personality disorder; Crisis; Crisis intervention; Therapeutic relationship; Health services; Integrative review

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