What non-pharmacological interventions are recommended for managing BPD in primary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
The primary role of primary care in managing borderline personality disorder (BPD) is focused on crisis management and appropriate referral to specialist services . Comprehensive psychological treatments for BPD are typically provided by community mental health services .

When a person with an established diagnosis of BPD presents to primary care in a crisis, non-pharmacological interventions include:

  • Assessing the current level of risk to themselves or others .
  • Asking about previous episodes and effective management strategies used in the past .
  • Helping to manage their anxiety by enhancing coping skills and helping them to focus on the current problems .
  • Encouraging them to identify manageable changes that will enable them to deal with the current problems .
  • Offering a follow-up appointment at an agreed time .

General principles for crisis management, which may also be useful for General Practitioners (GPs) with a special interest in BPD, include:

  • Maintaining a calm and non-threatening attitude .
  • Trying to understand the crisis from the person's point of view .
  • Exploring the person's reasons for distress .
  • Using empathic open questioning, including validating statements, to identify the onset and course of the current problems .
  • Seeking to stimulate reflection about solutions .
  • Avoiding minimising the person's stated reasons for the crisis .
  • Refraining from offering solutions before receiving full clarification of the problems .
  • Exploring other options before considering admission to a crisis unit or inpatient admission .
  • Offering appropriate follow-up within a time frame agreed with the person .

It is important to note that brief psychological interventions (of less than 3 months' duration) specifically for BPD or its individual symptoms should not be used outside of specialist services .

Related Knowledge Topics

Educational content only. Always verify information and use clinical judgement.