How can I support a patient with BPD in developing coping strategies during routine consultations?

To support a patient with borderline personality disorder (BPD) in developing coping strategies during routine consultations, maintain a calm and non-threatening attitude and use empathic, open questioning to understand the patient's distress and reasons for it, validating their feelings without minimising them.

Encourage the patient to focus on current problems and help them identify manageable changes and self-management strategies that can reduce anxiety and improve coping skills.

Discuss and review any existing crisis plan, including triggers and effective coping mechanisms, and offer follow-up appointments at agreed times to provide ongoing support.

Collaborate with the patient to develop or update a care plan that clearly identifies short-term treatment aims and steps the patient can take to manage distress, as well as long-term goals to underpin overall treatment.

When appropriate, consider referral to community mental health services for further assessment and support, especially if coping strategies are insufficient or risk levels increase.