How do art therapists structure their approach to borderline personality disorder?

• This paper outlines the understanding of the condition of borderline personality disorder, controversies around the diagnosis and its use by evidence based psychological therapies as a guide for structuring therapy.
• They surveyed art therapists internationally and received usable description of 226 interventions with over 140 names.
• The results indicate that most art therapists carefully prepare service users for treatment through sharing a clear understanding of the condition and treatment aims and pay particular attention to the attachment issues involved.

This paper outlines a study which sought to understand how art therapists structure their approach to treating people who experience borderline personality disorder features. It outlines the understanding of the condition, controversies around diagnosis and its use by evidence based psychological therapies as a guide for structuring therapy. The paper considers how art therapists might utilise research to improve art therapy for this distressing condition. The authors argue that before undertaking clinical trials, art therapists need to build theory inductively so that there is clarity about what is tested. They surveyed art therapists internationally to try to understand how whether there was consistency in how they structured their approach and received usable description of 226 interventions with over 140 names. The results indicate that most art therapists carefully prepare service users for treatment through sharing a clear understanding of the condition and treatment aims and pay particular attention to the attachment issues involved. The study concludes by suggesting any trial of art therapy with borderline personality disorder features should include these structures in the approach studied. The authors suggest that the existing taxonomy for art therapy does not describe the approach of practitioners take and recommend terminology should reflect structure and not therapist intentions.