Proposal for an Australian Model of Care providing accessible treatments for people living with borderline personality disorder
Sathya Rao, Rita Brown, Cathryn Pilcher, Marianne Weddell, Jillian H. BroadbearObjective
To define a comprehensive model of care that improves accessibility of treatments across primary, private and public mental health care sectors for people with borderline personality disorder (BPD) in Australia.
Methods
This Model describes a staged/tiered approach utilising brief, short- and long-term psychological treatments in individual or group therapy settings. These treatments utilise generalist (common factors) and specialist approaches, enhancing the capacity of healthcare providers to offer care, thereby improving access to appropriate evidence-based psychological treatments.
Findings
People experiencing milder symptoms of BPD may benefit from brief treatments employing a generalist psychotherapy approach. People with moderate to severe BPD may benefit from generalist/specialist approaches within the private and public sectors. People experiencing complex and high-risk BPD may require longer-term specialist psychotherapy and multidisciplinary care. Treatment type and duration should be tailored to the person’s presentation and needs, with clear pathways for escalation of care when required.
Conclusions
This model of care proposes that psychological treatment be delivered at a level and within a timeframe appropriate to each person’s needs and proximal to where they live. A Core Competency Framework, based on evidence-based common factors psychological treatment, can facilitate delivery of these services in a holistic, equitable, and streamlined manner.