Therapeutic Communication and Management Strategies for Borderline Personality Disorder

Running Head: MENTAL HEALTH AND BPD 0
Borderline Personality
Disorder
Student Details

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Therapeutic communication is a part of therapeutic relationship between the nurse and
patient or physician and patient. It is defined as the interaction with the patient face to face in
order to provide beneficial interventions related to the physical and emotional wellbeing. The
nurses use therapeutic communication in order built a communication to easily get the health
information of the diseased person. Therapeutic communication includes the interpersonal
communication which is intended to help the patient. In the given case scenario the patient is
suffering from the borderline personality disorder. It is a mental or psychological disorder
marked by some pattern of self-image, varying mood, and behavior (NIMH, 2017). The
patient has suffered a sexual abuse in her childhood and stresses due to the separation of her
parents. She has been feeling guilty as she blames herself for the divorce of her mother and
father and tried to commit suicide. In this case scenario, therapeutic communication can play
a vital role for the better patient recovery. This essay aims to develop a discussion about how
therapeutic communication can be beneficial in April's case. The skills required to develop
communication with the patient and management strategies that can be applied to treat the
disorder in this case scenario, will be discussed.
The epidemiological study of BPD shows that in the United States, 1.6 % of the total
populations suffering from this disorder. Which means over 4 million people have BPD in
America (Skodol, 2017). Women have the higher risk of developing this disorder than men.
Among all the people diagnosed with borderline personality disorder, seventy-five percent
are women with the ratio 3 females to one male. Some studies revealed that nearly 75 % of
the people diagnosed with BPD make at least one attempt to commit suicide in their lifetime
(Salters, 2018). The patient with borderline personality disorder shows various personality
related symptoms such as irritation, anger, suicidal thoughts and demotivated. Therefore they

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should be dealt with more care. The causes of this disorder include genetic factors,
environmental factors, and brain function. No specific gene is responsible for causing BPD;
however, this disorder has strong hereditary connections (Chanen, & Kaess, 2012). The
environmental factors include sexual or physical abuse and separation from the parents
during childhood. Some of the symptoms of BPD associated with the neurological basis of
the brain specifically the portion that controls decision making and emotions of the person
(NAMI, 2018). Nurses sometimes receive the verbal abuse from the person with BPD due to
their inappropriate anger which is not easy for them to control. Skills required to build a
therapeutic communication are different from the general interpersonal interaction. A nurse
skilled in therapeutic communication helps him or her to understand the patient better.
Communication is the important factor to initiate, elaborate and ends the relationship between
a nurse and the patient. To develop an effective therapeutic relationship a nurse must follow
some rules of confidentiality-safeguard and privacy of the patient's rights. A nurse should
allow the patient to express their thoughts, respect the person by considering the age,
background, religion, race and socioeconomic in respecting personal space
Nurses must control their own reaction to the frustration or anger. Building a
therapeutic relationship with the patient might help the nurses and other health providers to
provide better health care. Therapeutic communication is the first step in order to develop a
therapeutic relationship. To make a better therapeutic communication a mental health nurse
requires skills such as building trust, being empathetic, active listening, reflecting,
motivating, encouraging and hope to offer. Developing trust in a therapeutic relationship with
the patient is very essential. The patients with borderline disorder are not very open to
discussing their medical situation with the unknown person ((Beck, Davis, & Freeman,
2015). Therefore a nurse should develop trust. In this case, April has been blaming herself
for the separation of their parents as she disclosed about her sexual abuse to her parents. So it

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is possible that she may not easily discuss her feeling to the nurse but developing the trust
allows the patient to disclose how she is feeling and what she actually wants. This is the most
important skills every nurse should have in order to establish a good therapeutic
communication with the patient. Being empathetic is another essential skill for the nurse to
provide better interventions for the patient with the borderline personality disorder, although
empathy is confused with sympathy. Empathy allows the diseased person to develop a feeling
that they are not alone (Roepke, Vater, Preißler, Heekeren, & Dziobek, 2013).
Effective Communication with the clients is directly linked with active listening.
Active listening is the important part of therapeutic communication. Attentive listening is
more than just hearing and remaining silent. It allows the nurse to hear, process and
purposefully comprehending the patient’s words and processing the words to understand the
person’s situation and the signs and body language sent by the patient (Stoffers, Voellm,
Rücker, Timmer, Huband, & Lieb, 2012). In the case of April, this skill might help to assess
the problems associated with her mental illness and to help the client to express her feelings
completely. In some cases during the conversation the patient discuss something important,
that should be the focus of the nurses and asks the patient to continue those statements. This
develops a positive feeling that the nurse really wants to hear what is important to the patient.
In most of the cases the patient asks the nurses to advise them about the problems they have
and what they should do, in this scenario being reflective is very important to develop a
therapeutic communication. Sometimes it is useful to be silent and not speak at all. This can
give both patient and nurse an opportunity to think about what comes next. It can also
provide the patient time and space to understand the new topic. Using the touch method may
also be beneficial in April's case, it may enable a nurse to develop a feeling in patient that
somebody cares for her and she is not alone. While talking to the patient eye contact is
necessary so that the patient can believe that the nurse really wants to understand the problem