Systemic challenges and strategies for institutional settings

Caroline Giroux, Andrew M. Bein, Glen Xiong

Research output: Chapter in Book/Report/Conference proceedingChapter


The high prevalence of patients with borderline personality combined with their specific comorbid conditions increase the likelihood of encountering them in various institutional settings. With aging, they become at higher risk of medical complications. To maximize therapeutic efficacy, treatment infrastructures should be prepared to respond to such needs. Some pejorative labels commonly used by clinicians can help identify challenges inherent to serving that population and approaches can be adjusted accordingly. Encouraging self-awareness of emotional responses, self-regulation and validation at the staff level will help model beneficial skills among the patients themselves. From a case scenario to illustrate the challenges, this chapter will address three contributing sets of factors (patient, clinician, and situation) in difficult encounters. Three corresponding levels of strategies are illustrated, from screening and education to supervision groups and team approach to resource management.

Original languageEnglish (US)
Title of host publicationBorderline Personality Disorder in Older Adults: Emphasis on Care in Institutional Settings
PublisherNova Science Publishers, Inc.
Number of pages8
ISBN (Electronic)9781634822305
ISBN (Print)9781634822213
StatePublished - Apr 1 2015

ASJC Scopus subject areas

  • Psychology(all)
  • Medicine(all)


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