Borderline personality disorder and parenting: clinician perspectives

Borderline personality disorder (BPD) is a pervasive and debilitating mental health condition. Current literature suggests that children of families where a parent has a diagnosis of BPD may be particularly vulnerable to experiencing psychological and psychosocial difficulties. However, there is a limited understanding of the mechanisms by which difficulties may be transmitted from parent to child. Furthermore, fear of stigma and intervention from child protection services may be barriers to these parents engaging in research about their parenting experiences. An alternative source of information can be sourced from clinicians who work with these families in clinical contexts. This study aimed to explore mental health clinicians' perceptions of parenting problems that may be experienced by individuals with a diagnosis of BPD and clinicians' views on available parenting resources, supports or interventions for this cohort of families. Mental health clinicians were asked to provide their opinions via a voluntary and anonymous online survey. A total of 106 clinicians, trained in various disciplines and working in varied clinical contexts, participated from across four countries (Australia, USA, Canada and New Zealand). Thematic analysis revealed six themes relating to parenting problems within this population. These included disruption to empathic responsiveness, difficulties maintaining stable and/or safe environments, difficulty managing interpersonal boundaries, parenting skill deficits and poor parenting self-efficacy. An additional theme, capacity for adaptive parenting, was also identified. Finally, themes relating to effective and ineffective parenting resources, supports and interventions were discussed and recommendations were made for the development of future parenting interventions.