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1. Type of Treatment

  • Most patients will need extended psychotherapy to attain and maintain lasting improvement in their personality, interpersonal problems, and overall functioning.

  • Pharmacotherapy often has an important adjunctive role, especially for diminution of symptoms such as affective instability, impulsivity, psychotic-like symptoms, and self-destructive behavior.

  • Many patients will benefit most from a combination of psychotherapy and pharmacotherapy.

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2. Flexibility and Comprehensiveness of the Treatment Plan

  • Treatment planning should address borderline personality disorder as well as comorbid axis I and axis II disorders, with priority established according to risk or predominant symptomatology.

  • The treatment plan must be flexible, adapted to the needs of the individual patient.

  • The plan also must respond to the changing characteristics of the patient over time.

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3. Role of Patient Preference

  • Discuss the range of treatments available for the patient's condition and what the psychiatrist recommends.

  • Elicit the patient's views and modify the plan to the extent feasible to take these views and preferences into account.

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4. Single Versus Multiple Clinicians

  • Both are viable approaches.

  • Treatment by multiple clinicians has potential advantages but may become fragmented.

  • Good collaboration of the treatment team and clarity about roles and responsibility are essential.

  • The effectiveness of single versus multiple clinicians should be monitored over time and changed if the patient is not improving.

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
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