In 2019–2020, myself and two fourth-year occupational therapy students at Monash University collaborated to create a comprehensive resource guide.
This year-long project combined six months of research with six months of development and aimed to address the barriers and challenges occupational therapists face when working with individuals with Borderline Personality Disorder (BPD).
During the initial research phase, the team identified a common issue: stigmatising portrayals of individuals with BPD in professional literature, such as labels like “manipulative” or a “whirlwind of destruction.” These narratives negatively impacted clients’ care quality and highlighted inadequate training for clinicians. To address these gaps, the students conducted an online survey targeting mental health occupational therapists. The survey explored therapists’ attitudes, barriers, and resource needs when working with BPD.
Survey Insights The results echoed prior research, showing that clinicians need more training and support. Respondents highlighted the importance of practical, high-quality resources, such as online modules and therapist-led training, to improve their practice.
The Resource Guide In response, the team created a guide featuring carefully selected, high-quality online resources tailored to the needs and learning styles of occupational therapists. Additionally, the guide considered the perspectives of individuals with BPD in recovery, ensuring it met both clinician and client needs. To maintain quality, the team critiqued each resource using a robust evaluation template included in the guide for future reference.
Methodology Highlights The survey used a mix-method design, combining quantitative data (e.g., Likert scale responses on empathy, optimism, and knowledge) with qualitative insights (e.g., skills and challenges identified by therapists). The analysis incorporated both statistical summaries and content analysis to provide a comprehensive view. Ethical considerations were paramount, with the project following guidelines to protect vulnerable populations.
The survey included 74 mental health occupational therapists, with 95.9% (n=71) identifying as female. Nearly half (45.9%, n=34) had over five years of experience in mental health, while 16.2% (n=12) had four to five years, and 24.3% (n=18) had two years or less. Over one-third (n=27) cared for fewer than ten people with BPD in 2019, while 23% (n=17) cared for thirty or more. Most participants worked in community settings (54.1%, n=40) or inpatient settings (40.5%, n=30).
- Nearly half of the participants (45.9%; n = 34) had over five years of experience working as occupational therapists in mental health settings.
- This was followed by participants with four to five years of experience, comprising 16.2% of the respondents (n = 12).
Summary of Findings
Occupational therapists identified several challenges in working with individuals with BPD.
Specific workplace and healthcare system constraints, poor staff performance, ineffective teamwork, difficulties in providing treatment, challenges arising from consumer behaviors, shared therapist-consumer struggles, and widespread misunderstandings about BPD.
In contrast a supportive work environment for occupational therapists was found to be supportive of working with people with BPD. These elements including effective supervision, sufficient staff training, and strong teamwork.
These factors are crucial for fostering a positive environment that benefits both therapists and clients.
From these findings a resource guide was developed and I have been working on targetting my training and resources in response to these barriers.
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