In Australia the recent development of draft guidelines for the treatment of Borderline Personality Disorder (BPD) will set a standard for the provision of services for people with this disorder. It is therefore timely to review programs that are in place and consider how these programs fit with the proposed new national guidelines for the provision of comprehensive services informed by the recovery framework.
Dialectical Behaviour Therapy (DBT) is an evidence based treatment for BPD. Clients with this disorder have complex, multi-axial problems, are difficult to engage in treatment and intense transference and counter-transference issues can lead to clinician burnout.These problems are compounded when clinicians are working in isolated rural and remote areas.
This paper will describe the challenges and opportunities encountered in providing DBT treatment as part of community mental health services in a rural area. The DBT program has evolved over the past ten years to provide treatment for adults diagnosed with BPD as well as a DBT informed program for youth aged 14-24 years with emerging disorders of the self.
Clinical outcome data from both the adult and youth cohorts from the past three years of the program will be presented which shows reductions in service utilisation and improvements in quality of life. These outcomes indicate that DBT is a promising treatment that can be offered utilising the resources of a rural community mental health service.