Trust as a foundation for the therapeutic intervention for patients with borderline personality disorder

Abstract

A qualitative, exploratory, descriptive and contextual study using an 'interpretive descriptive approach' was undertaken in order to develop a practice-level model for the facilitation of mental health of patients diagnosed as having Borderline Personality Disorder by the community psychiatric nurse. The context of the study was the in the Psychiatric Community Services in the greater Johannesburg region, South Africa. Individual and focus group interviews were conducted with patients and mental health clinicians representing the multidisciplinary team with experience in managing the condition, either in a personal capacity or as professional mental health practitioners. Themes extrapolated from the transcribed interviews were further explored and a practice-based theory was constructed. This article reports on the first theme 'Trust', the concept identified by both patients and clinicians as crucial for the establishment and maintenance of the therapeutic relationship that forms the vehicle for care of patients with this disorder in psychiatric mental health care.

The Art of Helpful Relationships with Professionals: A Meta-ethnography of the Perspective of Persons with Severe Mental Illness

“…Furthermore, trust is a concept used to describe relationships with professionals that are helpful [22,27,29,41]. This entails to feel trust in professionals [21, 22, 24-28, 31-33, 35], as well as having mutual trust in the relationship, where the trusted professional trusts the individual in return [26,28,32,35,40].…”

“…One basic, helpful component is the opportunity of having long-term relationships [22, 24, 26, 28-30, 32, 34, 37]; something that is described as providing continuity [22,24,26,28,29] and consistency [32]. Trust can take a long time to develop [27,31] and this can be facilitated by long-term relationships [24,26,28,29,32]. Having relationships that lasts over time also makes it possible to really get to know each other [24,26,29,34,37,40], and gives the professionals better background knowledge to help with treatment and support [26,30,40].…”

“…Having relationships that lasts over time also makes it possible to really get to know each other [24,26,29,34,37,40], and gives the professionals better background knowledge to help with treatment and support [26,30,40]. It is also appreciated to have sufficient time for helpful processes and actions to take place [22,24,26,27,[31][32][33][34]38]. ''I had Lotta; at first I didn't like her, but after a while I liked her much better.…”

“…Furthermore, for professionals to be physically available, to be accessible and acknowledge requests when they occur [23, 24, 27, 29, 31-34, 37, 38, 41] and be able to help when challenges arise [22,23,27,30,31,36,39,41] is described as helpful. In addition, what can be called affective availability is described in the studies.…”

“…In addition, what can be called affective availability is described in the studies. This pertains to the fact that a professional is available for the individual because s/he cares about them, being there as a person for them [23,26,27,30,31,41]. ''She was there for me, not for her job or the system, but because she wanted to be'' [23, p. 476].…”