Being a case manager for persons with borderline personality disorder: Perspectives of community mental health center clinicians

The scope of case management has expanded to include persons with chronic, nonpsychotic disorders, in particular, persons diagnosed with borderline pe rsonality disorder. Despite more widespread use, literature about case mana gement for persons with this disorder is limited. To address this gap in kn owledge, a study of the day-to-day experiences of case managers who care fo r persons with borderline personality disorder was conducted. Seventeen com munity mental health center case managers gave their informed consent to pa rticipate in individual, in-depth interviews. The interviews were analyzed using an interpretive phenomenological research approach. The analysis show ed a pattern of monitoring self-involvement. The case managers monitored th emselves in terms of expressing concern and setting boundaries. These share d practices highlight a central and unique component of being a case manage r for persons with borderline personality disorder, that is, the case manag er's focus of attention is on self. By focusing on the self, case managers seek to retain control of the nature of the relationship. The author assert s that the matter to be resolved is not to determine whether retaining or r elinquishing control is better, but rather, how best to help practitioners maintain a helpful relationship over time with persons who have borderline personality disorder. In an effort to accomplish this goal, questions about current helping practices and suggestions for working collaboratively with persons who have this diagnosis are provided. Copyright (C) 2000 by W.B. S aunders Company.