If you think you (or a loved one) may have borderline personality disorder (BPD), the first step toward recovery is getting an accurate diagnosis. But what happens during the assessment process?
Starting a Borderline Personality Disorder Assessment
The first step to getting an accurate diagnosis is finding a mental health professional who is trained to work with people with BPD and making an appointment. This alone can be a challenge. It can be very anxiety provoking to think of taking this first step; many people avoid it for months or even years. But, once you make the decision to move forward, finding a clinician is not always easy.
There are resources that can help guide your search. If you have health insurance, you may want to talk to the insurance company about clinicians who take your insurance and who have expertise in BPD (you should also ask how many sessions would be covered and how much the co-pay would be). If you do not have insurance, you may qualify for public assistance programs or services through your state or region's department of mental health or social services.
As you search, keep in mind that you are looking to contact a professional who will conduct an assessment, give you a diagnosis, and either provide treatment or refer you to people who are an appropriate match. There are a number of different kinds of clinicians who can do this, including psychiatrists, psychologists, social workers, licensed mental health counselors, and psychiatric nurses. Generally, psychologists have the most training in psychological assessment (although this is not always the case), so you may want to start there (most psychologists will have a Ph.D. or Psy.D. after their name, but you may need to ask them if they are a licensed psychologist).
Scheduling a Borderline Personality Disorder Assessment
When you have found a list of professionals who might work, it is time to call and schedule an appointment. Call the first person on your list, and let them know that you are interested in an assessment and treatment. Describe some of your symptoms. You can even mention that you think you may have BPD.
Talk to the potential provider a bit about their educational background and training, and what types of services they can provide. Also ask if they have experience with BPD, what and how they charge (and confirm that they will accept your insurance if you have it). Ask what to expect in terms of the assessment process. This process will usually take more than a few minutes; the provider should be devoting at least a session, if not more, to assessing your difficulties (unless you have had assessments previously and the diagnosis is already established).
Keep in mind that you should feel comfortable with the clinician. Try to get a sense of that over the phone. Does this sound like someone you could talk to? Unfortunately, depending on where you live, you may not have too many options to choose from. But, try to choose someone who has the right expertise and who you feel comfortable with.
The Borderline Personality Disorder Assessment Process
When you arrive for your first session, you may feel nervous and uncomfortable, particularly if you have never done this before. This is completely normal. It is not easy to meet a new person and share private details about your life. However, keep in mind that the more candid and honest you can be, the more you will get out of the assessment.
Different providers use different tools to conduct an assessment. Generally, you should expect that your clinician will interview you and ask questions about your current and past symptoms, your family and work history, and your current life situation. Some clinicians will also give you some short questionnaires to fill out. Some may also use psychological tests that are longer and cover many different questions.
The assessment may take one session, or, if it is a very complete assessment, may take several sessions. Your clinician will let you know what to expect in terms of how long the assessment will take, and what types of tests or interviews you will be completing (if any).
Getting a Diagnosis
In some cases, at the end of the assessment, you may need to be referred to other additional types of assessment before a diagnosis can be given. For example, if you have a history of one or more significant head injuries, your provider may want you to see a specialist to evaluate whether some of your symptoms could be related to that. Or, if you have not seen a primary care physician (PCP) in some time, your provider may ask you to visit your PCP to make sure that any symptoms are not related to underlying medical conditions.
However, in most cases, you will receive a diagnosis at the end of the assessment. Your provider will also talk to you more about why you may be experiencing these kinds of difficulties and will recommend treatment options that may work for you. It may be that the clinician you have chosen can provide some of the treatment, or they may need to refer you to someone with different expertise. The good news is that you will now be able to move forward with the treatment that will be best suited for you.
Groth-Marnat, G. Handbook of Psychological Assessment. New York: John Wiley and Sons, 2003.