Effective management of borderline individuals in crisis

Persons with borderline personality disorder are a crisis prone population that are often seen simultaneously by outpatient therapists and staff from crisis/emergency agencies. Effective management of crisis episodes requires structure and consistency that can be attenuated by lack of coordination between therapists and case workers. This paper outlines a set of dilemmas presented by borderline clients in crisis and tactics for responding to these dilemmas that are drawn from basic tenets of crisis intervention and psychotherapy. It is proposed that a shared understanding of the dynamics of borderline crises and application of generic approaches can produce a coordinated response to borderline clients in crisis that is supportive and effective.