Family involvement BPD symptoms in an adolescent have a tremendous impact on his or her family; the greatest effect is suggested to be on their emotional health.52 The same study

also found that a majority of parents reported physical health problems and marital difficulties. In the same study of 233 female offspring meeting strict criteria for BPD, symptoms correlated with intensity of parental burden were acting-out behavior, property destruction, delusional symptoms, and hallucinatory symptoms.52 This suffering of the family Inhibitors,research,lifescience,medical has to be validated. Parents need to be told that their anger, guilt, or anxiety are normal and can be controlled to avoid an exacerbation of their child’s pathological Inhibitors,research,lifescience,medical behaviors. The therapist has to build on their strengths

and avoid blaming them. Not only is the family a valued ally as a source of information and the primary support of the adolescent, it is essential in the management of a teenager with a BPD. Indeed, an interview with the family enlightens the therapist on the relational mode of the patient and allows targeted interventions. Family Inhibitors,research,lifescience,medical work is important ATM Kinase Inhibitor molecular weight because the home environment often plays a major role in the adolescent’s behavior.53 Parents can help their child to use the skills learned in therapy and even use the same skills themselves. They may also learn to modify the way they respond to the patient’s pathological behaviors.53 Miller suggests Inhibitors,research,lifescience,medical they be partners rather than targets in treatment.53 Also, assuming that the environment influences the genetic vulnerability in the expression of the disorder, an intervention at the family level might be protective.16 Psychoeducation is the basis of the necessary intervention with the family. They need information about BPD; its symptoms,

what we know about its etiology, recommended treatments. Parents shall be taught about effective communication, behavior management, and problem-resolution strategies. While being validated regarding how much the situation is worrisome and frustrating, Inhibitors,research,lifescience,medical they can also be told that they can remain optimistic since something can be done. The therapist also has to be clear from the beginning through with the patient and his or her family about confidentiality issues. Confidentiality shall be broken if the patient’s safety is at stake, if there is a suicidal plan with an intent to act it out, a plan to seriously hurt oneself or someone else, or if there is a situation of physical or sexual abuse or neglect. Regarding self-mutilation, the DBT model proposes that we validate the parents’ worry while telling them that we won’t disclose every gesture unless it threatens life, or there is an uncontrollable escalation of the behavior. This will allow the adolescent to feel more comfortable to discuss his or her behaviors.