Clinician perspectives on recovery and borderline personality disorder

Pages199-209
Date08 May 2017
Published date08 May 2017
DOIhttps://doi.org/10.1108/JMHTEP-09-2016-0044
AuthorFiona Donald,Cameron Duff,Katherine Lawrence,Jillian Broadbear,Sathya Rao
Subject MatterHealth & social care,Mental health,Mental health education
Clinician perspectives on recovery and
borderline personality disorder
Fiona Donald, Cameron Duff, Katherine Lawrence, Jillian Broadbear and Sathya Rao
Abstract
Purpose Recovery is an important concept within mental healthcare policy. There is a growing expectation
that clinicians adopt approaches that align with the recovery principles, despite significant disagreements
about what recovery-oriented interventions might look like in practice. It is also unclear how recovery may be
relevant to personality disorder. This paper aims to discuss these issues.
Design/methodology/approach In total, 16 clinicians were interviewed at two mental health services in
Melbourne, Australia. These clinicians had specialist training and experience in the treatment of borderline
personality disorder (BPD) and provided insight regarding the meaning and relevance of the recovery
paradigm in the context of BPD. Thematic analysis within a grounded theory approach was used to
understand key themes identified from the interview data.
Findings Thematic analysis suggested that clinicians understand recovery in three distinct ways: as
moving towards a satisfying and meaningful life, as different ways of relating to oneself and as remission of
symptoms and improved psychosocial functioning. Clinicians also identified ways in which recovery-related
interventions in current use were problematic for individuals diagnosed with BPD. Different approaches that
may better support recovery were discussed. This study suggests that practices supporting recovery in BPD
may need to be tailored to individuals with BPD, with a focus on cultivating agency while acknowledging the
creative nature of recovery.
Originality/value Clinicians are in a strong position to observe recovery. Their insights suggest key
refinements that will enhance the ways in which recovery in BPD is conceptualized and can be promoted.
Keywords Qualitative methods, Thematic analysis, Borderline personality disorder, recovery, Clinician
Paper type Research paper
Introduction
The concept of personal recovery has grown in importance within mental healthcare policy for all
consumers, including individuals diagnosed with personality disorder (Le Boutilllier et al., 2011).
The concept of personal recovery originated during the early 1990s within consumer narratives
that contested the nature and quality of psychiatric care at that time (Davidson et al., 2010).
Subsequently, what was originally an outsiderconcept has been widely endorsed within
national healthcare policy. Within the Australian context of the current study, the stated aim of
national policy is to enable recovery, with recovery defined as involving the development
of new meaning and purpose and a satisfying, hopeful and contributing life as the person grows
beyond the effects of psychiatric disability(Commonwealth of Australia, 2010, p. 31).
The language of this definition of recovery mirrors the definitions from the consumer literature
(for instance, Anthony, 1993). Furthermore, there is an emphasis on the individual nature of
recovery and on care that is centred on the consumers needs, highlighting the positive influence
of consumer definitions of recovery on national policy.
The adoption of recovery concepts within public policy and in the language and practices of
professional treatment services remains controversial in Australia and elsewhere. The concept
of recovery arose in the context of the social justice claims of the survivor/consumer movement
(for instance Anthony, 1993; Deegan, 1997). The activism associated with these claims asserts
that mental health consumers/survivors have different and at times conflicting interests to those
Received 6 September 2016
Revised 17 December 2016
Accepted 3 January 2017
The authors wish to acknowledge
thecontributionofDrJ.SaburaAllen
to the early stages of this research
project.
Fiona Donald is based at the
School of Psychological
Sciences, Monash University,
Melbourne, Australia.
Cameron Duff is based at the
Centre for People Organisation
and Work, RMIT University,
Melbourne, Australia.
Katherine Lawrence is based at
the School of Psychological
Sciences, Monash University,
Melbourne, Australia.
Jillian Broadbear is a Senior
Research Fellow and
Sathya Rao is the Clinical
Director at the Spectrum
Statewide Service for
Personality Disorder, Eastern
Health, Melbourne, Australia.
DOI 10.1108/JMHTEP-09-2016-0044 VOL. 12 NO. 3 2017, pp. 199-209, © Emerald Publishing Limited, ISSN 1755-6228
j
THE JOURNAL OF MENTALHEALTH TRAINING, EDUCATION AND PRACTICE
j
PAGE199

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