1. Avoiding Disaster With Borderline Patients Risk Management Planning Gerald P. Koocher, Ph.D., ABPP

2. Avoiding Disaster with Borderline Patients Set firm boundaries and discuss them in a direct and empathic manner.Set firm boundaries and discuss them in a direct and empathic manner. Monitor your own reactions and “counter- transference.”Monitor your own reactions and “counter- transference.” Do not compromise out of a wish to “be more helpful.” Do not compromise out of a wish to “be more helpful.” Seek periodic consultation with a colleague who is experienced in work with such patients. Seek periodic consultation with a colleague who is experienced in work with such patients.

3. Avoiding Disaster with Borderline Patients Avoid becoming defensive if you are subjected to verbal attacks. If you sense problems or a complaint developing, get consultation early. Remain empathic, explain the reason for the boundaries, and remain firm. Remain empathic, explain the reason for the boundaries, and remain firm. Consult an experienced colleague, an attorney, or even your malpractice carrier. Consult an experienced colleague, an attorney, or even your malpractice carrier.

4. Avoiding Disaster with Borderline Patients Do not assume that a licensing board or ethics committee will understand borderline character pathology fully. The patient may contain his or her pathology during the complaint filing. Be prepared to educate and document the patient’s difficulties with solid case notes and support by contemporaneous consulting professionals.