Date Presented 04/22/2023

Little published information is available about OT interventions for people diagnosed with borderline personality disorder. This scoping review compiled psychosocial interventions that can be used by OT practitioners.

Primary Author and Speaker: Kelly Machnik

Contributing Authors: Hannah Ghneim, Annette Leep, Meghan Lloyd, Darcie Shaw, Stephanie Voelck, Barbara Harvey, Betsy Williams, Emily Nichols

Borderline Personality Disorder (BPD) is characterized in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), by a variety of symptoms that interfere with occupational participation and performance, such as unstable self-image, intense emotions, self-harm, and risky behaviors. In the United States (U.S.), BPD affects 1.6% of the population, or 4 million Americans. About 70% of people with BPD attempt suicide in their lifetime and 10% will complete suicide. Occupational therapists are distinctly qualified to address behavioral differences that impact occupational performance for this population; however, there is limited research that specifically focuses on occupational therapy (OT) interventions for people with BPD which is important for informing OT intervention planning. This scoping review analyzes current literature to identify OT interventions as well as psychosocial interventions that are used with those diagnosed with BPD. Electronic databases were systematically searched (PubMed, Web of Science Core Collection, PsychInfo, Psychology Database Journals, and CINAHL) and inclusion criteria for selection included adults diagnosed with BPD by the DSM-III, IV, or 5; interventions used by mental health professionals; and the article was in English. One hundred and fifty-five articles met the inclusion criteria. Of those articles, 11 mentioned OT practitioners as providing interventions, 9 study designs were identified, 39 types of interventions were examined, 22 countries were included, and publication years ranged from 1993 to 2022. A variety of evidence-based interventions applicable to this population were identified, such as Dialectical Behavior Therapy. Themes included awareness of behaviors and skill training to improve functional performance. The results of this research impact the profession by serving as a summary guide of evidence-based interventions that OTs can use with the population diagnosed with BPD.

References

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Matson, R., Kriakous, S., & Stinson, M. (2021). The experiences of women with a diagnosis of Borderline Personality Disorder (BPD) using sensory modulation approaches in an inpatient mental health rehabilitation setting. Occupational Therapy in Mental Health, 37(4), 311–331. https://doi.org/10.1080/0164212X.2021.1933674

Walton, C. J., Bendit, N., Baker, A. L., Carter, G. L., & Lewin, T. J. (2020). A randomised trial of dialectical behaviour therapy and the conversational model for the treatment of Borderline Personality Disorder with recent suicidal and/or non-suicidal self-injury: An effectiveness study in an Australian public mental health service. Australian & New Zealand Journal of Psychiatry, 54(10), 1020–1034. https://doi.org/10.1177/0004867420931164

Wasmuth, S., Mokol, E., Szymaszek, K., Gaerke, K., Manspeaker, T., & Lysaker P. (2020). Intersections of occupational participation and Borderline Personality Disorder: A grounded theory approach. Cogent Psychology, 7(1). https://doi.org/10.1080/23311908.2020.1803580