How Family Therapy Can Help Manage BPD

Happy family at guidance counseling
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If you have a loved one with borderline personality disorder (BPD), family therapy may be a helpful addition to traditional treatment plans. It's common for family members of those with mental health issues to feel overwhelmed by their loved ones’ symptoms and often need help understanding where how they can cope. By involving the whole household in therapy, BPD can be better managed by empowering the family to work together in a more effective way.

The Basics of Family Therapy

Family therapy is different than the traditional kind of psychotherapy that most people are familiar with. Rather than just one person and their therapist, family therapy involves the whole household working together with one or two therapists. This form of treatment typically involves the parents or siblings but can also include extended groups when appropriate.

Family therapy may be an option for you if the person with BPD is negatively impacting your family's daily life or if you think the actions of your household may be worsening BPD symptoms. Sometimes these two problems interact—the BPD symptoms impair family functioning and poor family functioning makes the BPD symptoms worse, creating a painful cycle that makes things more difficult for everyone involved.

Does It Work?

Research about how family therapy can benefit those with BPD is sparse but it is an increasing area of study with a great deal of potential. Group therapy including household members has been proven to be beneficial for other mental health disorders like bipolar disorder or depression, so the impact on BPD is promising. A small number of studies suggest that this type of therapy can lead to better communication, less conflict, and fewer feelings of burden and guilt in BPD families. If you have a teenager or a dependent family member, some clinicians believe that this approach may be particularly helpful for them. 

Other Types of Treatment

In addition to therapy, there are other resources available to you and your family. Family Connections is a reputable program that works with the family, without the person with BPD, so that they can openly discuss their situation. A 12-week program, your family will learn about BPD, coping mechanisms for working with the BPD relative and skills for the group as a whole to work more functionally.

Having a relative with BPD is difficult and can make you feel helpless; joining programs like Family Connections can provide you with strong support and resources to help you manage.

You can learn more about the Family Connections program from the National Education Alliance for Borderline Personality Disorder.

In addition to Family Connections, a variety of similar programs are available. For example, the National Alliance for Mental Illness (NAMI) offers the "Family-to-Family" program, which is similar to Family Connections but offers support to families coping with other kinds of major mental illnesses as well. You may even find a program or support group at a local hospital—you can try searching their website or call to find out if they offer services for families.

Finding Family Therapy

It is definitely not easy to find a family therapist with a specialty in this area for BPD, but it's becoming more common. Start with your loved one's current therapist and ask for a referral to someone who does family therapy. You may also check with your health insurance company to see whether they have referrals and whether the cost of this type of treatment will be covered.

You may also want to try the American Association of Marriage and Family Therapy’s therapist referral site.

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  • "Borderline Personality Disorder." National Institute of Mental Health. 2011.

  •  Hoffman PD, Fruzzetti AE, Buteau E, Neiditch ER, Penney D, Bruce ML, Hellman F, Struening E. “Family Connections: A Program for Relatives of Persons With Borderline Personality Disorder.” Family Process. 44(2):217-225, 2005.
  • Santisteban DA, Muir JA, Mena MP, Mitrani VB. „Integrative Borderline Adolescent Family Therapy: Meeting the Challenges of Treating Adolescents With Borderline Personality Disorder.” Psychotherapy: Theory, Research, Practice, Training. 40(4):251-264, 2003.
  • Workgroup on Borderline Personality Disorder. “Practice Guideline for the Treatment of Patients with Borderline Personality Disorder.” American Journal of Psychiatry 158: 1-52, 2001.

By Kristalyn Salters-Pedneault, PhD
 Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University.