Borderline Personality Disorders: A Case Study

Personality disorders greatly influence the dropout rates in treatment for homeless individuals. Of the cluster B personality disorders, borderline personality disorder is one of the most difficult to treat in homeless individuals due to its high comorbidity rate with other Axis I disorders and the patient’s difficulty in emotional regulation and maintaining stable relationships with others. Art therapy is often used as a complementary therapy to treat borderline personality disorder. While qualitative research exists examining the perceived effects of art therapy in treatment for personality disorders in the general population, there is little quantitative research examining its effects on treatment of borderline personality disorder in the
Borderline personality disorder is a cluster B personality disorder that is characterized by a pervasive pattern of instability in interpersonal relationships, self-image, impulse control, and affect regulation, and it is a disorder that faces high rates of comorbidity with other mental health disorders such as substance use disorders, anxiety disorders, and mood disorders (Connolly, Cobb-Richardson, & Ball, 2008; HCH Clinicians’ Network, 2003; Lieb, Zanarini, Schmahl, Linehan, & Bohus, 2004). Individuals with borderline personality disorder are vulnerable to homelessness because of their tendency to maintain volatile relationships with those around them, as well as for reasons that put others with mental illnesses at risk such as job loss, substance abuse, and lack of family support (HCH Clinician’s Network,
Researchers Salavera, Tricás, & Lucha (2013) performed a study examining treatment dropout rates among homeless individuals experiencing personality disorders. They found that of the three clusters of personality disorders, patients experiencing cluster B personality disorders were more likely to abandon treatment and patients with borderline personality disorder abandoned treatment in all cases. In a publication by the Health Care for the Homeless Clinician’s Network (2003), they report that some of the greatest challenges faced in the treatment of homeless individuals with borderline personality disorder is their inability to think dichotomously and effectively communicate clearly what is bothering them to their clinicians. Characterized by an inability to express and regulate their emotions and susceptible to comorbidity with chronic pain syndromes, borderline personality disorder patients may resort to using the language of physical pain to describe both their emotional and physical sufferings. This may lead to a series of costly treatments with no ultimate diagnosis in an area of practice where private setting costs and reimbursement for borderline personality disorder treatment is not funded for by insurance (HCH Clinicians’ Network, 2003). Research examining