Demonstrating adherence to guidelines for the treatment of patients with borderline personality disorder.
OBJECTIVE
To describe the development and implementation of General Psychiatric Management (GPM), a dynamically informed psychotherapeutic and case management approach along with symptom-targeted pharmacological interventions for the treatment of borderline personality disorder (BPD), derived from the American Psychiatric Association's (APA) guidelines for treating BPD.


METHODS
Clinician adherence to GPM was assessed using the General Psychiatric Management Adherence Scale (GPMAS), which measured the amount of emphasis accorded to therapeutic tools and strategies during individual therapy sessions. GPMAS surveys were completed by 9 different therapists every 6 weeks during 1 year for 50 patients.


RESULTS
GPMAS displayed excellent internal consistency and good-to-excellent test-retest reliability. The convergence between patient- and therapist-rated sessions was excellent. Mean levels of emphasis were significantly greater for GPM interventions than prohibited ones across all time points. The mean number of prescribed psychotropic medications was 2.3, and the most frequently prescribed class of medication was antidepressants, followed by neuroleptics.


CONCLUSIONS
From these results, we conclude that the clinicians were adherent to the outlined protocol and that the GPMAS is a valuable measure for demonstrating adherence to therapies based on the APA guidelines.
Kolla
Nathan J
NJ
Resident, Department of Psychiatry, University of Toronto, Toronto, Ontario. nathan.kolla@utoronto.ca
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Paul S
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McMain
Shelley
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Streiner
David L
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Cardish
Robert
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Cook
Michele
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