Family therapy for borderline personality disorder (BPD) may be a helpful addition to traditional BPD treatment plans. Why family therapy for BPD? Family members of people with BPD frequently report feeling overwhelmed by their loved ones’ symptoms, and often need help understanding where these symptoms come from and how they are best managed. Family therapy for BPD may also help reduce symptoms by helping the family function in a healthier way.
The Basics of Family Therapy for Borderline Personality Disorder
Family therapy is a bit different than the traditional kind of psychotherapy that most people are familiar with. Rather than just one person (such as the person with BPD) and their therapist, family therapy involves the whole family, working together, with one or two therapists. Family therapy typically involves the immediate family (such as parents, spouses, siblings), but can also include extended family when appropriate.
Family therapy is usually suggested when either the BPD symptoms are negatively impacting the functioning of the family, or when problems in the family may be making the BPD symptoms worse. Sometimes these two problems interact -- the BPD symptoms impair family functioning, and poor family functioning makes the BPD symptoms worse. This kind of vicious cycle can be addressed in family therapy.
Does Family Therapy for Borderline Personality Disorder Work?
Unfortunately, little research has been done to examine whether family therapy for BPD reliably reduces BPD symptoms or improves family functioning. However, a small number of case reports and one study suggest that this type of therapy can lead to better communication, less conflict, and fewer feelings of burden and guilt in BPD families. Many clinicians suggest that this approach is particularly helpful with BPD adolescents or other individuals who are still dependent on their families (such as living at home or getting significant support from family members).
Other Types of Treatment for BPD Families
In addition to therapy, a newly developed treatment that is specially designed for BPD families may be worth considering. The program, called “Family Connections” is not family therapy in the traditional sense because it does not involve the person with BPD directly. Instead, family members attend this program without their BPD relative.
Over the course of the program, family members learn information on BPD, coping skills, and family skills. The program also offers a supportive community. A preliminary study shows that this approach can reduce grief and burden and increase feelings of mastery in BPD family members.
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 different kinds of major mental illness. You may even find a program at a local psychiatric hospital -- try searching their website or call to find out if they offer support services for families.
Finding Family Therapy for Borderline Personality Disorder
It is definitely not easy to find a family therapist with a specialty in family therapy for BPD, but they are out there. Start with your (or 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 this type of treatment will be covered).
For more ideas, check out “Finding a BPD Therapist.” You may also want to try the American Association of Marriage and Family Therapy’s therapist referral site (referrals are listed for families outside of the U.S. on this site.)
Workgroup on Borderline Personality Disorder. “Practice Guideline for the Treatment of Patients with Borderline Personality Disorder.” American Journal of Psychiatry 158: 1-52, 2001.
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.