Therapeutic interventions in Australian primary care, youth mental health settings for young people with borderline personality disorder or borderline traits
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Abstract
Background: This study aimed to investigate what therapeutic interventions were being applied by clinicians working with young people with a diagnosis of Borderline Personality Disorder or borderline traits in Australian primary mental health care settings. Given the current lack of evidence-based guidelines for treatment with this client population, investigating what is being implemented is needed. The study also aimed to determine whether the interventions clinicians are using are effective in reducing distress and increasing functioning for these clients. Methods: Participant data came from the national minimum data set for headspace youth mental health centers across Australia. Young people’s data were included in the study if the young person was diagnosed with Borderline Personality Disorder or borderline traits during their first episode of care ( N = 701). Clinician data that indicated the type of intervention used at each client session and outcome measures routinely captured were analyzed to determine interventions used and outcomes achieved. Results: Results demonstrated that CBT was the most frequently used modality of intervention followed by supportive counselling and IPT, but that most clients received a variety of intervention types. There were no or only weak relationships between changes in outcomes and the amount of any type of intervention that was provided. No significant relationship was found with the amount of CBT a client received and changes in symptoms or functioning, despite being the most commonly employed modality. Conclusions: The study highlights the need for evidence-based treatment guidelines for early intervention in young people with borderline personality disorder traits.
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Young persons with BPD remain largely undetected in primary services, are not referred to appropriate treatment, and are rarely provided appropriate, evidence-based treatments.
“Data from the Netherlands [14] as well as Australia [15] show that young persons with BPD remain largely undetected in primary services, are not referred to appropriate treatment, and are rarely provided appropriate, evidence-based treatments.”
From The (cost-)effectiveness of early intervention (MBT-early) versus standard protocolized treatment (CBT) for emerging borderline personality disorder in adolescents (the EARLY study): a study protocol for a randomized controlled trial (2024) · cites this paper as [15]
The Conclusion (page unavailable) says that young people with identified BPD traits received a wide range of interventions, most with a limited evidence base. But the Methodology includes only clients already identified with BPD or borderline traits; the study does not establish that young people with BPD are largely undetected or not referred to appropriate treatment. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn a study on primary care in Australia for 12- to 25-year-olds, patients with BPD symptoms showed no progress or deteriorated in social and occupational functioning (45%), psychological stress (60%), and quality of life (69%).
“In a study on primary care in Australia for 12- to 25-year-olds, for instance, patients with BPD symptoms showed no progress or deteriorated in terms of social and occupational functioning (45%), psychological stress (60%), and quality of life (69%) [15].”
Data from the Australian Headspace program for 12- to 25-year-olds found that 40% of young people with BPD features showed no progress at all after six sessions, while another 40% deteriorated; 57% deteriorated in social functioning and 69% for quality of life.
“Data from the Australian Headspace program for 12-to 25-year-olds found that 40% of young people with BPD features showed no progress at all after six sessions, while another 40% deteriorated. Moreover, 57% of youth deteriorated in terms of social functioning and 69% for quality of life (61).”
From The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescence (2023) · cites this paper as [61]
Less than 1% of young people in primary care services were diagnosed with BPD (features), and they received a variety of treatments, none specifically designed for BPD, often in a very low dosage, with a mean of 3.4 sessions.
“Australian data provide a similar picture, showing that less than 1% of young people in primary care services were diagnosed with BPD (features). These young people received a variety of treatments, none of them specifically designed for BPD, and often in a very low dosage, with a mean of 3.4 sessions (61).”
From The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescence (2023) · cites this paper as [61]
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- Authors
- O’Dwyer, N., Rickwood, D., Buckmaster, D., & Watsford, C.
- Affiliations
- University of Canberra (AU)
- Corresponding author
- Watsford, Clare
- Venue
- Borderline Personality Disorder and Emotion Dysregulation
- Published
- 2020-10-01
- Volume
- 7
- Issue
- 1
- Pages
- 23-23
- ISSN
- 2051-6673 (ISSN-L)
- PMC
- PMC7542340
- OpenAlex
- W3092343755
- Cited by
- 22
- References
- 45
- Citations by year
- 2026: 6 · 2025: 1 · 2024: 2 · 2023: 6 · 2022: 5 · 2021: 2
- FWCI
- 1.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Borderline Personality Disorder and Emotion Dysregulation (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- borderline personality disorder, borderline personality traits, youth mental health, primary care mental health, therapeutic interventions, cognitive behavioral therapy, interpersonal psychotherapy, supportive counseling, treatment outcomes, early intervention, evidence-based treatment guidelines, youth
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