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Core Principles of Care


There are several evidence-based treatments for BPD, such as Dialectical behaviour Therapy (DBT), Mentalization-Based Treatment (MBT), Schema-Focused Therapy (SFT) and Transference-Focused Psychotherapy (TFP). However, these may require many years of mastery and often have limited availability. Recently, structured generalist approaches have been developed drawn from the core principles of ‘what works’ from these specialist therapies. They have been proven to work for people experiencing BPD.

The core principles of care can be easily incorporated in the practice of health professionals, expanding access to treatment, and working to ensure that every interaction can be therapeutic.

Whilst these principles have been developed for health professionals that can also guide how family/friends/kin and supporters can do to be in a more sustainable relationship for everyone.  It is important to note that we are not suggesting that you become their therapist – they still need you to be their mum, dad, partner, child, friend, supporter etc and to do everyday things and activities with them.

The core principles are:


  • Focus on building a collaborative and trusting relationship
  • A strong therapeutic alliance is crucial
  • Aim to build mutual respect, active collaboration, and shared decision-making.
  • Be active and responsive
  • Treat the person as an individual, collaborating with them, i.e. “doing with” rather than “doing to”
  • Foster trust to allow strong emotions to be freely expressed
  • Be human and be prepared to acknowledge both the serious and funny side of life where appropriate
  • Seek to be educated and informed by those living with BPD/Lived Experience- what works for them


  • Remember aspects of challenging behaviours have survival value given past experiences
  • Be compassionate
  • Demonstrate empathy
  • Stay calm
  • Remain respectful
  • Remain caring
  • Engage in open communication
  • Listen to the person’s current experience
  • Take the person’s experience seriously, noting verbal and non-verbal communications
  • Maintain a curious and non-judgemental stance


  • Family/friends/supporters can become active allies in the person’s care and support team (unless inappropriate)
  • Acknowledge, respect and validate their contribution, and their emotional distress
  • Help support families, partners and carers of people with BPD by:
    • Arranging contact with any support services
    • Use language that conveys hope and optimism
    • Giving them clear, reliable information about BPD
    • Refer to ongoing supports


  • People living with BPD can lead meaningful lives
  • Build and help the person maintain motivation
  • Encourage a sense of agency balanced with support as needed
  • Focus on life situations – relationships and vocation
  • Integration of skills into daily life


  • Validate the person’s current emotional state
  • Convey encouragement and hope about the person’s capacity for change whilst validating their current emotional experience
  • Maintain hope even when the person may be feeling none


  • Structured (manual directed) approach
  • Be clear, consistent, and reliable
  • Work with the person to explain the diagnosis. Does it resonate for them?
  • Help the person make connections of feelings to events and actions
  • Collaboratively define goals of treatment
  • Schedule regular sessions
  • Use a systematic approach to addressing specific therapeutic tasks or topics.
  • Provide psychoeducation
  • Clear limits of what the therapist can and can’t provide
  • Collaboratively develop a treatment (wellness plan) involving family and/or carers
  • Teach emotional awareness, distress tolerance, coping techniques, skills and strategies to recognize, understand, and regulate their emotions in less/non-harmful ways
  • Focus on the emotions underlying the person’s action/s
  • The therapist accessing their own supervision and support

For more information about these core principles please refer to:

Clinical Practice Guideline for the Management of Borderline Personality Disorder (2012) (PDF, 1.5MB)

Project Air Strategy Treatment Guidelines and intervention manuals for Personality Disorders

NICE (National Institute for Clinical Excellence) Guidance Quality Standard: Personality disorders: borderline and antisocial

Services for people diagnosable with personality disorder, January 2020 Royal College of Psychiatrists (UK) Position Statement

For more information on BPD

BPD Co Shell like logo with a rainbow of colour

Spectrum Resources

Whether you are seeking help or information on mental health services.
Find resources

Project Air Factsheets

Information and tools for families, carers and people living with BPD. 
Find factsheets

Australian BPD Foundation resources

Support for those experiencing BPD and family members.
Search resources

BPD clinical practice guidelines

Guidelines for the management of BPD.
See guidelines
BPD Co Shell like logo with a rainbow of colour

BPD Collaborative

Services and resources for people experiencing mental distress and their supporters.
See website

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