Recovered Voices: Experiences of Borderline Personality Disorder

The purpose of this article is to use poetic analysis to present evocative accounts of the lived experiences of individuals who have recovered from Borderline Personality Disorder (BPD). Individuals with BPD suffer from a complex set of clinical issues that may be worsened by stigmatization encountered in their general lives as well as from health care providers. I argue that one method of enhancing clinical service provision to individuals with BPD is to view their behavior within the context that it originally developed. Viewing behavior in context may enhance healthcare providers’ abilities to respond empathically and/or to assist clients in generating meaningful solutions to problems associated with BPD. The poems offered here represent six individual stories of the experience of BPD. These poems may serve as a reminder of the painful and often tragic circumstances in which “borderline” behaviors can develop. They may also be useful as tools to assist trainees in developing better understanding of how to work with individuals with BPD effectively and compassionately

Managing Student Suicidality on Campus: Perspectives from Diverse Student Affairs Staff

Suicidal behavior is a substantial public health issue faced by college campuses. College counseling professionals often interact with a variety of other student affairs professionals who may be involved in the management of suicidality on campus. However, research on their experiences and perspectives on this topic is scarce. In this study, we build on literature related to management of suicidality on campus, which is predominantly focused on campus counseling professionals. Fifteen semi-structured qualitative interviews were conducted with student affairs professionals to explore how professionals on campuses might better work together to prevent crises and support students at elevated risk for suicide. Recurrent and emerging themes included barriers impeding their ability to best serve suicidal students, their perceptions on what factors make students vulnerable to suicide, and suggestions for future research. We conclude with a discussion of options to increase quantity and quality of service provision on campus for suicidal students

Recovery from Borderline Personality Disorder through Dialectical Behavior Therapy

This article presents a qualitative investigation of the perspectives and experiences of recovery from borderline personality disorder from six individuals who were treated with comprehensive dialectical behavior therapy. Data were collected via semi-structured interviews, transcribed, and coded using a six-step analysis process. Six primary themes emerged: (1) belief about recovery, (2) current experience of self, (3) facets of recovery, (4) motivating factors, (5) external supports to recovery, and (6) characteristics required for recovery. Overall, the findings took a dialectical form in which participants often described conflicting experiences (e.g., feeling recovered while also continuing to experience heightened emotional sensitivity). We conclude that the themes presented in this article represent broad domains related to the meaning of recovery from BPD, and recognize that the relative importance of each domain is best determined by the individual

Dialectical Behavior Therapy in College Counseling Centers: Practical Applications and Theoretical Considerations

Authors over the last two decades have discussed the myriad of challenges present in managing college students with severe mental health disorders. During the same time period, Marsha Linehan developed dialectical behavior therapy (DBT) as an empirically sound intervention for individuals with suicidal and self-injurious behaviors and this treatment grew to be an evidence-based practice for a range of challenging clinical issues. I argue that one solution to continued increases in college students who present for treatment to their college counseling centers with difficult-to-treat mental health issues, including but not limited to, borderline personality disorder (BPD), is to implement DBT programs on college campuses. As such, the purpose of this dissertation is to address both practical and theoretical issues in the implementation of DBT in college counseling centers. In chapter two, I begin by presenting an overview of DBT as a comprehensive treatment model and a review of the research to date related to DBT in college counseling centers. In chapter three, I offer a detailed account of the program development and implementation process of the DBT program housed in the college counseling center at Florida Gulf Coast University. In chapter four, I present an investigation of current trends and barriers to implementation of DBT in college counseling centers. Finally, in chapter five, I present a qualitative inquiry of the experience of BPD as told by individuals who have been successfully treated with DBT. I argue that understanding client experiences and behaviors in context is critically important if one is to be able to respond empathically and compassionately. In essence, these chapters represent my attempt to synthesize two areas that I believe are required for successful implementation of DBT programs that provide good quality care: 1) Navigating the complexities of implementing DBT in college counseling centers as practice setting and 2) Appropriate management for clinician biases and tendencies to stigmatize BPD clients, which interferes with their ability to provide care that is both effective and compassionate

Dialectical Behavior Therapy in College Counseling Centers: Practical Applications and Theoretical Considerations

Authors over the last two decades have discussed the myriad of challenges present in managing college students with severe mental health disorders. During the same time period, Marsha Linehan developed dialectical behavior therapy (DBT) as an empirically sound intervention for individuals with suicidal and self-injurious behaviors and this treatment grew to be an evidence-based practice for a range of challenging clinical issues. I argue that one solution to continued increases in college students who present for treatment to their college counseling centers with difficult-to-treat mental health issues, including but not limited to, borderline personality disorder (BPD), is to implement DBT programs on college campuses. As such, the purpose of this dissertation is to address both practical and theoretical issues in the implementation of DBT in college counseling centers. In chapter two, I begin by presenting an overview of DBT as a comprehensive treatment model and a review of the research to date related to DBT in college counseling centers. In chapter three, I offer a detailed account of the program development and implementation process of the DBT program housed in the college counseling center at Florida Gulf Coast University. In chapter four, I present an investigation of current trends and barriers to implementation of DBT in college counseling centers. Finally, in chapter five, I present a qualitative inquiry of the experience of BPD as told by individuals who have been successfully treated with DBT. I argue that understanding client experiences and behaviors in context is critically important if one is to be able to respond empathically and compassionately. In essence, these chapters represent my attempt to synthesize two areas that I believe are required for successful implementation of DBT programs that provide good quality care: 1) Navigating the complexities of implementing DBT in college counseling centers as practice setting and 2) Appropriate management for clinician biases and tendencies to stigmatize BPD clients, which interferes with their ability to provide care that is both effective and compassionate

Knowledge, Attitudes and Expectations of Physicians with Respect to Palliative Care in Ecuador: A Qualitative Study.

Background: The worldwide need for palliative care is high, especially in mid- income countries like Ecuador, where the percentage of patients receiving such care is very small due to the scarcity of infrastructure and specialized personnel and to the unequal distribution in the country. The objective of this study is to explore the knowledge, attitudes and expectations related to palliative care of the physicians in Ecuador. Methods: A qualitative study based on 28 semi-structured interviews, from March 2014 to November 2016, with physicians working in four cities in Ecuador recruited through the snowball technique. Thematic analysis was developed supported by the ATLAS.ti software. Results: Five core themes were identified: (1) training, (2) health policy, (3) professionals' activities, (4) health services and (5) development of palliative care in Ecuador. Conclusions: Strategies are needed which intensify the training of medical professional in palliative care, as well as avail the human resources and materials for providing it