Recovery in borderline personality disorder: time for optimism and focussed treatment strategies

Borderline personality disorder (BPD) is prevalent, debilitating and clinically challenging. The evolving field of intervention and outcomes in BPD research is considered with a focus on recent research.

A pattern of clinical and functional improvement is to be expected in patients experiencing BPD. Specialized psychotherapies are shown to be beneficial, but generalist, low-intensity interventions in nonspecialized centres are also showing efficacy. Long-term naturalistic studies show that remission of the disorder is common and promising outcomes are not only possible, but likely. Training in vocational functioning, improving personal competence and promoting resilience needs to be further developed.

BPD diagnosis does not need to overwhelm clinicians, nor does it require therapeutic pessimism. Targeted interventions, including meaningful psychoeducation, are helpful in promoting optimism and enhancing recovery-oriented treatments.