TREATMENT: What to look for in a therapist?

[BPDFamily.com]

You wouldn't see a nurse as a "clinician" and talk about their talent, while arguing that the MD/DO doesn't mean squat. 

No ... .on the other hand, I've been a patient of nurse practitioners - an even nurses - who seemed to know much more what they were doing than some MDs. At least in some areas.

And I know for sure who I'd rather have give me a shot or draw blood ... .

Interesting discussion - I think there are some good points all around.

[Auspicious]

You wouldn't see a nurse as a "clinician" and talk about their talent, while arguing that the MD/DO doesn't mean squat. 

No ... .on the other hand, I've been a patient of nurse practitioners - an even nurses - who seemed to know much more what they were doing than some MDs. At least in some areas.

And I know for sure who I'd rather have give me a shot or draw blood ... .

Interesting discussion - I think there are some good points all around.

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[an0ught]

No ... .on the other hand, I've been a patient of nurse practitioners - an even nurses - who seemed to know much more what they were doing than some MDs. At least in some areas.

And I know for sure who I'd rather have give me a shot or draw blood ... .

As long as we seek THE ONE solution we are bound to fail. The question is not who is the best but who is the best for what task? So what are the basic tasks. I really don't know but since I'm not a trained professional I don't have to stop   and refer you to one. So here we go:

1) diagnosis

2) individual therapy

3) DBT therapy in a structured format

4) medication

5) clinical treatment of severe episodes

I suspect the questions one would need to ask are very different in each case. For e.g. diagnosis the ability to form a relationship quickly, emotional self awareness and a very good clue about BPD vs. bipolar and other stuff. Plus a good idea about the possible courses of action. But while analytical capabilities are helpful a lot more important later is the ability to lead the BPD sufferer through change and sustain the relationship. Whether you find both capabilities in the same person expressed to a greater extent is not so clear.

When it comes to Ph.D.'s in psychology it is at least in my country a good indicator that the person has a grasp on basic statistics. Whether that is relevant or not for treatment - I doubt it. But is may be an indication of abstract thinking and that is useful considering the games that are played with us by our SOs.

[Am I crazy?]

I have a therapist that I have been talking to, but have decided that she is not what I need.  She listens well, but I know that she does not understand the hell my family is going through.   She insists that to "fix" this, that I need to sit down with the unBPD and tell her that I would like us to "fix" this, so that the family can be whole again.  My DS has tried talking his unBPD wife into going to therapy, or couples therapy or group therapy and her answer is, ALL of you are crazy and ALL of you need to go.  I am the only sane person.   Well, folks, NO SHE IS NOT!  She is the one that has brought all this hell into our lives.  So, back to my question.  I need to find a therapist who is familiar with BPD.   I live in North Carolina.  Any suggestions?

[Cherokeeflower]

Is there a good reference site for therapists who specialize in BPD and the people that care about them?

[sosadandone]

Hi

  I am a long term member but I wanted to post something I think is important for everyone so Im posting it here. I recently read a post from a non having issues with their BPD's current Therapist. For those of you who have followed my story my exBPD ended up a disaster because of his own T.But here is the substance of what I want to get out there. I also don't want to make any sweeping generalizations so read carefully- this applies to Many but not ALL therapists. The goal of this post is to help people CHoose wisely.

  Many  therapists, including but not limited to MSWs. PsycD, PHds, Addiction counselors etc... DO NOT have training in extreme psychopathology especially BPD. However I suspect that many of these same people are reluctant to turn away a patient let alone a BPD who is easily develope a dependency on them. More importantly BPDs are absolute masters at both perceiving and portraying themselves as victims inducing rescue fantasies in their therapists. The result is that some T's will fail to properly dx the BPD and in many many instances will only re-inforce the BPDs persecution complex. Its becomes a seriously maladaptive cycle wherein the BPD traingulates using the T to get whatever they want; whether its antipathy towards the Non or med changes or just validation that nothing is wrong with them. Herein the real problem- what use is a T who is just taking money in exchange for ratifying a mentally ill person's denial. If anything these serious countertransferance abuses lead to only more difficult. In my own case- it was a disaster and my ex BPD is probably a whole lot worse for his T.

  I dont know how many people will read this but... .someone posted that while a non has little rights talking about the BPD with their T, we are completely within our own rights to ask the T exactly what was his/her training, education and precise experience working with BPDs. If they don't answer- you got a huge red flag that the person your BPD is seeing to help - may in fact only be hurting them. So here are some suggestions

a) Find out about credentials, training and education regarding the types of mental health issues they deal with

b) You have an absolute right to know how much experience the T has with BPDs.

c) Check with the local dept of ed to make sure their licenses are real and up to date

d) A great resource is the National Degree Clearinghouse data base which keeps diploma records

e) Ask about the experience the T has with CBT, DBT, Transferance Based therapy and anything else that applies

SSD

[anirab]

Some therapists are versed in DBT but don't necessarily sponsor the skills workshops required to be a 'certified' dbt therapist.  The other day, I found a DBT teacher who is not certified to teach due to this workshop limitation.  He mentioned that therapists who do 'trauma' work are often trained in DBT.  Perhaps you can google 'trauma' therapist.  Hope this helps. 

[sosadandone]

I dont want to generalize but really "trauma therapy". Sounds like PTSD psychobabble to me

I wonder if Linehan keeps a list of approved Ts/

That would seem the only way to go

Otherwise a BPD is a T's wet dream; someone willing to come as often as possible keep paying just dont ever tell them the truth

A psych I dated once joked; First I tell pts they wont get better until my youngest graduates prof school

And those are the good ones

Caveat EMptor

[krena]

How do you find a Dialectical Behavior Therapist? We are in Arkansas - I can't seem to find any information.

We are also only an hour to an hour and a half from Tulsa Oklahoma.

Thanks.

[blackandwhite]

It isn't always easy to find a provider, so here are some places to look:

Psychology Today has a good therapist look up: www.therapists.psychologytoday.com/rms/prof_search.php

Insurance companies often have lists of providers, with specialties and profiles listed, that you can access online (if you are a member of that insurance group).

DBT Self Help has announced it is partnering with another group to provide a comprehensive list of DBT therapists (still pending as of the time of this post but apparently coming soon):

A Worldwide DBT Database will be available for anyone who is looking for a DBT therapist or group in their area. This database will be provided in partnership with GoodTherapy.org. The actual database and search engine will be available on this website. DBT therapists and Centers offering DBT groups will find a coupon for 2 months free listing which they can use to sign up via GoodTherapy.org.

The current list of resources (soon to be replaced) is here: www.dbtselfhelp.com/html/resources.html

Your local NAMI affiliate may have resources for referrals.

[Randi Kreger]

I came across a therapist who was very astute with a BPD/NPD comorbid diagnosis and I asked her her advice to find more like her.She said that private therapists screen out axis ll patients and are inexperienced, so your best bet to find someone with a great deal of experience (which is what you want most of all) is to find people who have experience at places where:1) they did not have a choice as to clients 2) they were most likely to get clients with axis ll (PD) disorders.So where?1) Free or low cost clinics2) People with experience in prisons or domestic abuse and things like that. Some 30% of people in prisons have BPD and I am sure they are crawling with narcissists and antisocials as well. Look at Brandon Marshall, the new face of BPD.

[blackandwhite]

Another search engine resource (for the U.S.): www.findacounselor.org/. Listings are not comprehensive but the site is easy to use and information is good.

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[blackandwhite]

DBT Self Help has announced it is partnering with another group to provide a comprehensive list of DBT therapists (still pending as of the time of this post but apparently coming soon):

A Worldwide DBT Database will be available for anyone who is looking for a DBT therapist or group in their area. This database will be provided in partnership with GoodTherapy.org. The actual database and search engine will be available on this website. DBT therapists and Centers offering DBT groups will find a coupon for 2 months free listing which they can use to sign up via GoodTherapy.org.

GoodTherapy.org has a searachable database that includes "dialectical behavioral therapy" (as well as "schema therapy" and other relevant therapy types for our members) under "Type of Therapy." Database is international, though I cannot speak to how comprehensive the listings are.

[tcevans78]

Hi,

I'm not sure if this is appropriate here on this board - or site in general.  Please move -or even delete I suppose- if necessary.  

I am relocating to the St Louis area and am terrified I will not find a good therapist there.  Can anyone recommend someone who has BPD experience?  

Thank you!  

[Want2know]

You can start by taking a look at the Resources and Download tab on the Home page.

https://bpdfamily.com/discussions/family-resources.htm

Let us know if that helps.

[JimNelson89]

This might be a good source for help or recommendations in your area:

www.emp-dbt.com/index.htm

I am also looking for a therapist that does DBT.  I live in Southern California.  Are there resources for finding a qualified person.

[GreenMango]

This might be a good source for help or recommendations in your area:

www.emp-dbt.com/index.htm

I am also looking for a therapist that does DBT.  I live in Southern California.  Are there resources for finding a qualified person.

Jim,

Have you checked out any of these sites for referrals?

It isn't always easy to find a provider, so here are some places to look:

Psychology Today has a good therapist look up: www.therapists.psychologytoday.com/rms/prof_search.php

Insurance companies often have lists of providers, with specialties and profiles listed, that you can access online (if you are a member of that insurance group).

DBT Self Help has announced it is partnering with another group to provide a comprehensive list of DBT therapists (still pending as of the time of this post but apparently coming soon):

A Worldwide DBT Database will be available for anyone who is looking for a DBT therapist or group in their area. This database will be provided in partnership with GoodTherapy.org. The actual database and search engine will be available on this website. DBT therapists and Centers offering DBT groups will find a coupon for 2 months free listing which they can use to sign up via GoodTherapy.org.

The current list of resources (soon to be replaced) is here: www.dbtselfhelp.com/html/resources.html

Your local NAMI affiliate may have resources for referrals.

-GM

[JimNelson89]

Thank you GreenMango

But how do I get the search to only look for people who offer DBT?

[GreenMango]

Thank you GreenMango

But how do I get the search to only look for people who offer DBT?

JimNelson

It's going to take some legwork on your end.  To my knowledge there is not a BPD/DBT specialty referrals website for clinicians (If anyone knows of one please let the staff here know)

If you go into the either the Psychology Today link www.therapists.psychologytoday.com/rms/prof_search.php

you need to select "borderline personality disorder" under the issues menu.  It does not have a DBT specific option.  But therapists who have "experience" with BPD come up.  Some use DBT, some don't.  You need to check their individual profiles for a DBT specialty.

Through the dbt-self help link to www.goodtherapy.org under the advanced search options you can select both your region and type of therapy dialectical behaviorial therapy.  You will need to check if they are experienced with people with BPD.

Now both of these will pop up a variety of clinicians with varying degrees of experience, education, and philosophies.  It is important to ask questions and interview the potential therapists.

This post from page one of this thread may be helpful as a starting point:

Maybe this could be made a sticky in case others ask :

From BPD Demystified , Robert O. Friedel, MD -

"John Gunderson described well the responsibilities of the primary clinician"

- Educate the patient about the nature and causes of Borderline Disorder

- Ensure that all appropriate evaluations are performed in order to determine the patients specific needs

- Develop with the patient a comprehensive treatment plan that best meets these needs

- Ensure the plan is implemented

- Routinely determine the patients safety and progress in treatment

- Implement changes in the treatment plan when indicated  

- Ensure communication among other therapists, if any , who are involved in the patient's treatment


And from Stop Walking on Eggshells by Randi Kreger and Paul T. Mason, MS  -

   Asking the clinician questions designed to evaluate the persons competence at treating patients with BPD -

1. Do you treat people with BPD? If so how many have you treated? Watch the therapist's body language and tone of voice to determine their attitude about BPD clients. We suggest you avoid therapist's who do not hav a lot of experience with borderline problems.

2. How do you define BPD? If the therapist knows less than you do keep looking. If the therapist thinks BPD is part of another disorder that you do not have, move on.  ( for example they may believe that BPD is really a form of Post-Traumatic-Stress-Disorder, yet you have no history of trauma.)

3. What do you believe causes BPD? If you are a non-abusive parent of a BP and the therapist believes all BPD is caused by parental abuse, we urge you to find a more compatible therapist. Also if the clinician does not mention possible biological causes, they are probably not up to date on the latest research.

4. What is your treatment plan for clients with BPD? Look for someone who can give you a clear overview of the treatment they provide, but who also says that treatment is modified for each individual. Therapist's who do not have a treatment plan tend to be diverted by BP's crises and never seem to get around to addressing long-standing issues.

5. Do you provide a specific treatment for self-injury? Substance abuse? Eating disorders? Loved ones of those with BPD? Substitute or add your own concerns here.

6. Do you believe that borderlines can get better? If so have you personally treated BP's who improved? According to Santoro and Cohen (1997), " what you want to hear is reasonable optimisim. No one can give you a guarantee( if they do, skip them). If they hedge their bets too much, it is probably better to move on to someone else." Make sure that you and the therapist share the same goals.

7. What are your views on medications? If the therapist is not a psychiatrist , ask who would prescribe them, if any are needed.

 Hope this helps others. I am going to give this to my dBPDF if she doesn't have me go with her.

-GM

[PaGuy]

I tried searching and didn't find anything... .

I am starting to look for a therapist to help me get rid of my   , and I would like some guidance.  I would prefer someone with experience with helping adult children of a uBPDm, but I also want to make sure the person can actually help and not just look good on paper.

What questions have you found helpful/did you wish you asked a therapist before you started therapy with him/her? What qualities did you appreciate in a therapist that help you deal with your   ?  Thanks for your help!

[GreenMango]

Looking for a therapist when you have a parent with BPD could involve narrowing your search for therapists that were familiar with PDs.  Then calling the therapist's office and asking the therapist some questions about their focus, therapy style, years as a therapist, etc.

[coasterhusband]

Yesterday was my first personal/individual session with a new therapist. It was just me, and I found him by asking our MC (who includes BPD as her specialties) who she recommended. (This was a 1:1 call between me and the MC)

I have to say, and couldn't recommend more to all of you here on this board: Find a T that is trained in/experienced with BPD. Wow oh wow does it make a difference. In 20 minutes, he understand my needs and situation and next steps better than 6 sessions with my last non-BPD trained T.

May seem obvious, but if it wasn't to me, maybe it's not to others.

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[Wanda]

 

ya i went to a therapist also who knew about BPD most counselors do not you have to attend a therapist one who would know about BPD it helps a great deal... . they help you learn the skills and tools to live with a BPD... .

[A Dad]

Hi all,

Does anyone happen to know of a good psychologist/therapist around Amsterdam (Netherlands) who can work with me in diagnosing my wife's possible BPD?

Kind regards

[Reg]

I think that this site can help you further on this matter :

https://www.stichtingborderline.nl/site/Voorlichting/Activiteitenagenda

[Reg]

Graag gedaan ! Succes !

I think they may put you on the right track towards experienced people on the matter.

[coanon]

Hi all -

I'm currently living in Beijing, and my partner has a number of symptoms of BPD if not a formal diagnosis.  The options for english-speaking therapists here are pretty limited, so I'm wondering if anyone knows a good therapist who is willing to work over skype?  I know it's far short of ideal, but we desperately need help and I want to find someone who gets the BPD behavior pattern and ideally practices DBT.  My partner has already been through a number of therapists with little success.

Any leads welcome, thank you!