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Handbook of Good Psychiatric Management for Borderline Personality Disorder

John G. Gunderson, M.D.
With Paul S. Links, M.D., F.R.C.P.C.

  • ISBN 978-1-58562-530-7
  • Item #62530
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The diagnosis and treatment of patients with BPD can be fraught with anxiety, uncertainty, and complexity. How welcome, then, is the Handbook of Good Psychiatric Management for Borderline Personality Disorder, which teaches clinicians what to do and how to do it, as well as what not to do and how to avoid it. The author, a renowned researcher and clinician, has developed a new evidence-based treatment, Good Psychiatric Management (GPM) that comfortably utilizes cognitive, behavioral, and psychodynamic interventions that are practical and simple to implement. Because psychoeducation is an important component of GPM, the book teaches clinicians how to educate their patients about BPD, including the role of genetics and the expected course of the disease. This approach offers advantages both to practitioners, who become more adept at honest communication, and to patients, who are encouraged to have realistic hopes and to focus on strategies for coping with BPD in daily life.

The book is structured for maximum learning, convenience, and utility, with an impressive array of features.

  • Section I provides background on BPD, including the myths that sometimes discourage clinicians from treating these patients and that hamper the effective treatment of the disorder.
  • Section II, the GPM Manual, provides a condensed and clear description of the most essential and specific GPM interventions that clinicians can learn from and use in everyday practice.
  • Section III, the GPM Workbook, offers case vignettes which reference chapters from the manual. Each vignette has a number of decision points where alternative interventions are proposed and discussed.
  • To further facilitate learning, a set of nine interactions is found in a series of online video demonstrations. Here, readers can see in vivo illustrations of the GPM model in practice.
  • Finally, a set of appendices provides critical information, such as a comparison of GPM with other evidence-based treatments of BPD, scaling risk and response strategies, and family guidelines.

Designed to be a basic case management text for all hospital, outpatient clinic, or office-based psychiatrists or mental health professionals who assume primary responsibility for the treatment of those with BPD, the Handbook of Good Psychiatric Management for Borderline Personality Disorder constitutes a breakthrough in the treatment of these often misunderstood patients.


  • Preface
  • Acknowledgements
  • Section I: Background
  • Chapter 1. Introduction to good psychiatric management (GPM)
  • Section II: GPM manual: Treatment Guidelines
  • Chapter 2. Overall principles
  • Chapter 3. Making the diagnosis
  • Chapter 4. Getting started
  • Chapter 5. Managing suicidality and nonsuicidal self-harm
  • Chapter 6. Pharmacotherapy and comorbidity
  • Chapter 7. Split treatments
  • Section III: GPM Workbook: Case Illustrations
  • Chapter 8. Case illustrations
  • Section IV: GPM Video Guide: Demonstrations of the Approach
  • Chapter 9. Video demonstrations
  • Appendix A: Relation of GPM to other evidence-based treatments for BPD
  • Appendix B: Common features of evidence-based treatments for BPD
  • Appendix C: Safety Planning: An Example
  • Appendix D: Guidelines for Families
  • References
  • Index

About the Authors

John G. Gunderson, M.D., is Professor of Psychiatry, Harvard Medical School, and Director, BPD Center for Treatment, Research and Training, McLean Hospital, Belmont, Massachusetts.

Paul Links, M.D., M.Sc., F.R.C.P.C., is Professor and Chair, Department of Psychiatry, Schulich School of Medicine and Dentistry, The University of Western Ontario, and Chief of Psychiatry, London Health Sciences Centre and St. Joseph's Health Care, London, Ontario.

The 'G' in 'GPM' doesn't stand for 'good' or 'general', but for 'genius'. To distill the effective component of thousands of hours of clinical work with borderline patients into a single, readily implemented, evidence-based protocol takes genius. This book is written by two of the most respected psychiatrists in the field, whose combined wisdom will guide clinicians in their work with some of the most challenging patients. The book is not dogmatic, yet provides the most coherent and most empowering set of suggestions for the clinical treatment of BPD today.—Peter Fonagy, Ph.D., FBA, Freud Memorial Professor of Psychoanalysis, University College London; Director of the Mental Health Programme, UCLPartners Academic Health Science Network

This book shows how practitioners can apply evidence-based principles to the management of patients with BPD without having to refer patients to more specialized but less accessible clinics. It is a practical guide to real-world therapy.—Joel Paris, M.D., Professor of Psychiatry, McGill University

This book is for all mental health professionals who encounter people with borderline personality disorder and ask 'What can I do that is helpful?'. Here you will find the answers. Drawing on a lifetime of experience, John Gunderson skillfully provides information, illustrations, self-assessment tests, and intriguing decision-making clinical examples to lead you towards the realization that you, too, can be an important part of effective treatment.—Anthony W. Bateman, FRCPsych, Visiting Professor, University College London; Honorary Professor in Psychotherapy, University of Copenhagen

Gunderson, the master clinician for borderline patients, has done it again, only better. After multiple editions of his classic monograph, Borderline Personality Disorder, he brings us right into his consulting room with this new Handbook. We join him with patient after patient, following his wise roadmap of decision points along the tricky treatment trail. For clinicians interested in the best way to help borderline patients, it doesn't get any better than this.—John M. Oldham, M.D., Senior VP and Chief of Staff, The Menninger Clinic; Professor and Executive Vice Chair, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine

The handbook is a basic training manual in case management of Borderline Personality Disorder (BPD) and how to become confident in dealing with these patients. The premise of the book is to have all psychiatrists become 'good enough' to treat these patients first-hand. The authors have done an amazing job of packing together rich information regarding how to handle everyday challenges and solve dilemmas by making solid decisions. The handbook is a clear advantage beyond all other teaching material prepared so far of how to manage borderline patients. It represents a treasure trove of readily usable knowledge and it offers the reader immediately useful therapeutic tools for decisions. It is a handbook full of insight by two frontier researchers and clinicians in borderline personality disorders. Their wealth of clinical wisdom will empower the reader and case manager. I recommend this book to all psychiatric residents, the psychiatric staff in psychiatric departments, psychiatrist in private practice and to general practitioners, whose aim is to handle these patients in a professional way and to feel comfortable doing so.—Erik Simonsen, M.D., Ph.D., Professor of Psychiatry, Roskilde University & Institute of Personality Theory and Psychopathology; Director, Unit of Psychiatric Research, Region Zealand, Denmark

Overall, I find this Handbook to be extremely important and to fill an important gap in the literature on BPD. It provides a fairly straightforward guideline for treating BPD that is available to the typical mental health professional. That is a huge contribution. The evidence-based treatments can at times be intimidatingly prescriptive and require expensive, intensive training. This leaves the bulk of clinicians who do not have the time and money to get that training and yet have to take care of people with BPD (as it is so common) with a sense of uncertainty and inadequacy. The present Handbook helps clinicians build on their basic skill set to become empowered to treat this sometimes difficult group of patients. I therefore find it to be a major contribution that we need desperately in our field.—Antonia S. New, M.D., Prof, Psych & Dir, Med Student Educ, Dept of Psych, Icahn Scl of Med at Mount Sinai; Co-Dir, Clin & Translational Research, Mntl Illness Research & Educ Ctr, James J Peters VAMC

This is an excellent book for treating patients with BPD. There are too many useful features to enumerate, but what I found most interesting is the data that most BPD patients get better with good enough treatment and do not need to be managed through high-level tertiary care centers. This book provides clinicians with the guidelines and the confidence to treat borderline patients, including those who have not had training or supervision related to this problem. Of particular importance is that Dr. Gunderson's approach is flexible and pragmatic, in recognition of the fact that each clinical situation is different, and that he addresses many clinicians' fears of liability, suicidality, and hostile/negative borderline patient interaction that almost all of us have experienced. I highly recommend this book for anyone treating patients with borderline personality disorder.—Brett C. Plyler, M.D., Doody's Book Review

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