A Four-Stage Model for Management of Borderline Personality Disorder in People With Mental Retardation

Successful treatment of borderline personality disorder (BPD) among individuals with mental retardation (MR) in residential settings is complicated by the feelings of helplessness, confusion, and hostility often generated among direct support staff responsible for treatment. Effective staff training and presentation of the treatment plan in a simple, proactive format increases staff understanding and competence and thus enhances successful treatment. In this paper, a four-stage format for behavioral and psychiatric intervention in people with BPD and MR in residential settings is presented. A case study illustrating the effective implementation of the model in a 48-year-old woman with MR and BPD, living in a community group home, is also presented.