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Applications of Good Psychiatric Management for Borderline Personality Disorder

A Practical Guide

Edited by Lois W. Choi-Kain, M.D., M.Ed., and John G. Gunderson, M.D.

  • ISBN 978-1-61537-225-6
  • Item #37225

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Practitioners encounter patients with borderline personality disorder (BPD) with surprising frequency; indeed, 1 in 10 emergency room visits and 1 in 20 primary care appointments are estimated to involve people with BPD. Applications of Good Psychiatric Management for Borderline Personality Disorder: A Practical Guide was written not for the psychiatrist engaged in lengthy and complex psychotherapy with these patients but for the generalist who needs the basic skills to deliver good care to this sizeable patient population in need of help. This guide condenses the vast expanse of the latest scientific research and describes the use of good psychiatric management (GPM) with different patient populations, in conjunction with different modalities, for different professions, and in different treatment settings. Constructed carefully by two leading psychiatrists in the field of BPD, the book is designed for maximum utility with stand-alone chapters offering clear guidelines for managing BPD.

Topics and features include the following:

  • Case vignettes, which are designed to make the book practical and eminently useful, provide decision points where alternative interventions are proposed and discussed, demonstrating how to apply the concepts outlined in the chapter. Although the authors review the relative merits of these interventions, the presentation promotes active learning and the ability to adapt to unpredictable clinical realities.
  • Challenges to implementing GPM that are specific to a particular treatment setting—consultations, inpatient and outpatient settings, emergency departments, and colleges—are directly addressed so the guidelines are immediately relevant to the target audience of each chapter.
  • Clinicians from a variety of fields, including social workers, primary care providers, psychopharmacologists, and training supervisors, care for patients with BPD, and the book makes concrete suggestions about how to apply GPM in a range of practice types.
  • Implementation of GPM in a brief format and how it can be applied to other personality disorders is also addressed. It explains how GPM can be integrated with other evidence-based treatments for BPD, such as dialectical behavior therapy, mentalization-based treatment, and transference-focused psychotherapy.

Written in a down-to-earth style, this case management text will appeal to the resident on call, the specialist, and the generalist. Above all, Applications of Good Psychiatric Management for Borderline Personality Disorder: A Practical Guide addresses the challenges specific to different treatment contexts to help busy clinicians provide informed, effective care for their patients with BPD.


  • Preface
  • Chapter 1. An Overview of Good Psychiatric Management: Origins and Directions
  • Part I: Clinical Services
  • Chapter 2. Inpatient Psychiatric Units
  • Chapter 3. Emergency Departments
  • Chapter 4. Consultation-Liaison Service
  • Chapter 5. Generalist Adult Outpatient Psychiatry Practice
  • Chapter 6. College Mental Health Services
  • Part II: Providers
  • Chapter 7. Social Workers
  • Chapter 8. Primary Care Providers
  • Chapter 9. Psychopharmacologists
  • Chapter 10. Psychotherapy Supervisors
  • Part III: Implementation and Integration
  • Chapter 11. Implementation of Good Psychiatric Management in Ten Sessions
  • Chapter 12. Implementation of Good Psychiatric Management for Narcissistic Personality Disorder: Good Enough or Not Good Enough?
  • Chapter 13. Integration With Dialectical Behavior Therapy
  • Chapter 14. Integration With Mentalization-Based Treatment
  • Chapter 15. Integration With Transference-Focused Psychotherapy
  • Part IV: Conclusion
  • Chapter 16. Conclusion: The Future of Good Psychiatric Management
  • Appendix A: Additional Resources
  • Appendix B: Stepped Care Model
  • Appendix C: Interpersonal Coherence Model


    Karen A. Adler, M.D.
    Claire Brickell, M.D.
    Dr. Patrick Charbon
    Jessica Droz, M.D.
    Robert P. Drozek
    Ellen F. Finch
    Richard G. Hersh, M.D.
    Victor Hong, M.D.
    Gabrielle, Ilagan, B.A.
    Evan A. Iliakis, B.A.
    James A. Jenkins, M.D.
    Stephane Kolly, M.D.
    Ueli Kramer, Ph.D.
    Paul S. Links, M.D.
    Deanna Mercer, M.D.
    Brian A. Palmer, M.D., M.P.H.
    Daniel G. Price, M.D.
    Ana M. Rodriguez-Villa, M.D.
    Anne K.I. Sonley, M.D., J.D.
    Brandon T. Unruh, M.D.
    Igor Weinberg, Ph.D.

About the Authors

Lois W. Choi-Kain, M.D., M.Ed., is Assistant Professor in Psychiatry in the Department of Psychiatry, Medical and Program Director of Gunderson Residence at McLean Hospital in Belmont, and Director of McLean Hospital Adult Borderline Center and Training Institute of Harvard Medical School in Boston, Massachusetts.

John G. Gunderson, M.D., is Professor of Psychiatry, Emeritus, at Harvard Medical School in Boston and Consultant in Psychiatry at McLean Hospital in Belmont, Massachusetts.

Borderline personality disorder has long been one of the most vexing conditions encountered by mental health practitioners. This new volume by Choi-Kain and Gunderson has provided a systematic, clearly written guidebook that is a model of clarity for clinicians. It anticipates the common problems that will present themselves and offers wise and practical solutions for them. It is a marvelous contribution to the field. If you can only buy one book on the subject of borderline personality disorder, this is the one you want.—Glen O. Gabbard, M.D., Clinical Professor of Psychiatry, Baylor College of Medicine

Although the book is lengthy, the division of sections pertaining to treatment settings and provider types makes it widely relevant to providers working with patients with BPD. The authors are successful in their goal of reaching the generalist audience with this approach. This is a first edition, but it does expand upon a comparable book intended specifically for mental health professionals, Handbook of Good Psychiatric Management for Borderline Personality Disorder, Gunderson. Overall, this book makes a strong contribution to resources for generalists working with the BPD population—Hannah EH Williams, M.D., Doody Reviews

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