Katsakou, C; Pistrang, N; Barnicot, K; White, H; Priebe, S; (2017) Processes of recovery through routine or specialist treatment for Borderline Personality Disorder (BPD): a qualitative study. Journal of Mental Health 10.1080/09638237.2017.1340631. (In press).

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Abstract

Background: Recovery processes in borderline personality disorder (BPD) are poorly understood. / Aims: This study explored how recovery in BPD occurs through routine or specialist treatment, as perceived by service users (SUs) and therapists. / Methods: SUs were recruited from two specialist BPD services, three community mental health teams, and one psychological therapies service. Semi-structured interviews were conducted with 48 SUs and 15 therapists. The “framework” approach was used to analyse the data. / Results: The findings were organized into two domains of themes. The first domain described three parallel processes that constituted SUs’ recovery journey: fighting ambivalence and committing to taking action; moving from shame to self-acceptance and compassion; and moving from distrust and defensiveness to opening up to others. The second domain described four therapeutic challenges that needed to be addressed to support this journey: balancing self-exploration and finding solutions; balancing structure and flexibility; confronting interpersonal difficulties and practicing new ways of relating; and balancing support and independence. / Conclusions: Therapies facilitating the identified processes may promote recovery. The recovery processes and therapeutic challenges identified in this study could provide a framework to guide future research.

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