A qualitative exploration of the experience of community mental health clinicians working with people with borderline personality disorder in the context of high risk of suicide or self-harm

Abstract

Working with people with Borderline Personality Disorder (BPD) is often viewed as challenging, especially when there is a high risk of suicide or self-harm. This study aimed to provide insight into the lived experience of clinicians working with these service users within community mental health teams.Unstructured interviews were conducted with four participants from two multidisciplinary teams within the same NHS trust. Transcripts were analysed using Interpretative Phenomenological Analysis.Three superordinate themes were identified. (1) All participants emphasised the stressful nature of their role, describing its emotional impact and contributory factors, including organisational and relational issues. (2) Coping strategies were evident, which may not always have been within the participants’ awareness. (3) The task of balancing seemingly opposing possibilities was identified, paralleling the need for people with BPD to resolve dichotomous thinking.There is a role for counselling psychologists in helping clinicians working within multidisciplinary teams to develop a deeper understanding of their responses through training and supervision. This could in turn enhance the care provided.