Borderline Personality Disorder In Adolescents :
I have written elsewhere about why some mental health clinicians are reluctant to diagnose borderline personality disorder (BPD) in adolescents. However, when an adolescent is believed to be suffering from this extremely serious psychiatric condition, family therapy can be of potentially crucial importance.
What Is Family Therapy?
Quite simply, family therapy is a form of counselling that treats more than one member of the family in the same therapy sessions; this is predicated on the notion that the behaviour of a specific individual within the family is intimately connected to how other family members interact with him/her. (Two related posts that I have previously published about this phenomenon are: ‘Did Your Dysfunctional Family Make You Identified Patient?’ and ‘The Dysfunctional Family’s Scapegoat’).
How Does Family Therapy Help?
The aim of family therapy is to educate all its relevant members about :
- how family dynamics influence and maintain the behaviours of individuals within it
- communication within the family
- how adaptive (desirable) behaviours can be reinforced
- ways in which the family can collaborate (work together) to solve problems within the family
It is often the case that, prior to such therapeutic intervention, the adolescent, due to his/her ‘acting out‘, was seen (by the other members of the family) as the source of the family problems but, as the therapy sessions unfold, it becomes apparent that, in fact, the collective dysfunction of the whole family is at the root of the issue.
It is also not infrequently the case that through the process of family therapy it is revealed that other members of the family, too, have serious psychological conditions which need addressing (e.g. many adolescent sufferers of BPD will have a parent with the same condition or a similar personality disorder such as narcissistic personality disorder). When this found to be the case, such parents can also be helped (assuming they are willing) by the therapist which can, in turn, help them to relate to their family in a healthier way, hopefully culminating in a less dysfunctional relationship between them and their adolescent child.
Another very important aspect of family therapy is the therapist’s close observation of non-verbal communication between the parents and the adolescent (e.g. body language, facial expressions, intonation etc). By carrying out such observations, the therapist can point out to the family when such non-verbal signals may be less than helpful.
Family therapy can also include group training in parenting skills which can provide parents with :
- emotional support
- advice on how to create less dysfunctional family environments
- how to set their children good examples / be good role models
- how to reinforce their child’s positive behaviours
David Hosier BSc Hons; MSc; PGDE(FAHE).