Good psychiatric management: a review.

Borderline personality disorder (BPD) has moved from being an untreatable disorder to a disorder with multiple evidence-based psychotherapies. When a second generation of research showed that less intensive, easier-to-learn therapies could be nearly as effective, they offered an approach that would be responsive to the persisting unmet needs of these patients. This paper describes good psychiatric management (GPM), a once-weekly, generalist model that medicalizes the disorder, emphasizes psychoeducation, and focuses on social adaptation. It is proposed that this approach be the primary intervention for BPD; more intensive evidence-based psychotherapies thereby reserved for those who fail to respond. It is also suggested that whether GPM's focus on social adaptation yields significant effects that improve outcome in this domain deserves testing.