ABSTRACT
Interpersonal hypersensitivity (IHS) is a core organizing concept of Good Psychiatric Management, a generalist treatment for borderline personality disorder (BPD) that relies on basic tools most clinicians already employ yet is informed by an organized and evidence-based framework, developed for dissemination in various mental health care settings. We work in an inpatient psychiatric unit that specializes in the management of suicidal crises at the University Hospitals of Geneva, Switzerland. Because we see numerous patients with previously undiagnosed BPD during their first hospitalization, we have developed techniques and instruments to promote efficient and easy-to-implement psychoeducation. In this article, we propose a practical and user-friendly measure of IHS that is well-suited for use by multidisciplinary inpatient staff or outpatient nursing-based staff, the IHS Ruler, which is based on a visual analog scale. It is a pragmatic tool for preliminary psychoeducation for patients with BPD and their caregivers. Its ease of use and structured way of presenting the inner experience of these patients in relation to their current interpersonal environment allows caregivers to establish a framework for internal reflection and sharing, discuss the causes of current transactions, and illuminate larger patterns in the causes of the patient's crises. Ultimately, this process can help patients and the clinical staff supporting them anticipate future problems.
Subject(s)
Borderline Personality Disorder , Humans , Borderline Personality Disorder/therapy , Patient Education as Topic/methods , Interpersonal Relations , Adult , SwitzerlandABSTRACT
This article presents basic notions of "Good Psychiatric Management" (GPM) for Borderline Personality Disorder (BPD). There have been several evidence-based psychotherapeutic treatments for BPD for several decades. Nevertheless, high requirements and motivation required sometimes have a discouraging effect for trainees. GPM aims at offering «good enough¼ and less difficult to implement care. This article presents the notion of Interpersonnal Hypersensitivity and its different attachment states (attached, threatened, abandoned, and desperate) describing internal coherence of BPD and founding therapeutic interventions. GPM is principle based, thus is highly adaptable, as can be seen in integration with other intervention models or implementation of stepped care.
Cet article présente les bases du «Good Psychiatric Management¼ (GPM) pour le trouble de la personnalité borderline. Il existe pour ce trouble différents traitements psychothérapeutiques fondés sur les preuves. Les exigences importantes que ceux-ci représentent en termes de formation et de motivation ont parfois comme effet de décourager les thérapeutes en formation. Le GPM décrit des soins «suffisamment bons¼, accessibles et moins difficiles à implanter. Cet article présente le concept d'hypersensibilité interpersonnelle qui décrit la cohérence interne du trouble et fonde les interventions thérapeutiques. Le GPM est basé sur l'application de principes, ce qui lui donne une adaptabilité importante, par exemple pour l'intégration avec d'autres modèles d'intervention ou des soins par paliers.
Subject(s)
Borderline Personality Disorder , Borderline Personality Disorder/psychology , Borderline Personality Disorder/therapy , Humans , Motivation , PsychotherapyABSTRACT
This article addresses the health needs of unaccompanied undocumented minors (UMs) received in Geneva. In our experience and according to the literature, the most frequent diagnoses in this population are depression, anxiety disorder, posttraumatic stress disorder and substance abuse. Their medical and psychological treatments are often complicated by their psychosocial difficulties as well as by their wandering. Their treatment should be given by a multidisciplinary care team that works with the different structures that support them both socially and administratively. The adolescent health unit of the Geneva University Hospital give them the opportunity to reclaim their physical and mental health. It also enables them to bond with others and rethink their future trajectories.
Cet article propose d'aborder les besoins de santé des mineurs non accompagnés non requérants d'asile accueillis à Genève. Dans notre expérience et selon la littérature, les diagnostics les plus fréquents dans cette population sont les troubles anxiodépressifs, l'état de stress post-traumatique et les abus de substances. Leur prise en charge, souvent compliquée par leurs difficultés psychosociales et leur errance, devrait se faire par une équipe pluridisciplinaire de soins ainsi qu'en réseau avec les différentes structures qui les soutiennent sur le plan social et administratif. L'Unité santé jeunes (USJ) des Hôpitaux universitaires de Genève leur propose des espaces pour se réapproprier leur santé tant physique que psychique, afin de leur donner la possibilité de se lier à l'autre et de repenser leur errance.
