QUESTIONNAIRE FOR PROFESSIONALS
1) What is your degree? ________________ (psychiatrist, physician, psychologist, M.S.W., LCSW, etc.)
2) How long have you been in practice? ___________________
3) How do you get professional satisfaction treating patients with the borderline personality disorder (BPD)?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
4) Do you find BPD patients difficult to treat, and if yes, how do you handle this?
____________________________________________________________________________________
____________________________________________________________________________________
5) How do you approach treating friends or loved ones of people with the BPD? ____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
6) How many borderlines have you treated? _________________________
7) How many borderlines are currently on your case load?
___________________________
8) Do you believe the BPD has a strong medical basis?
_____________________________________________________________________________________
_____________________________________________________________________________________
9) What do you believe is the prognosis for the BPD?
_____________________________________________________________________________________
_____________________________________________________________________________________
10) How do you handle self-mutilatory borderlines?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
11) If you prescribe medications, how familiar are you with the medical research on treatment?
_____________________________________________________________________________________________________________
____________________________________________________________________________________
12) For therapists: Are you familiar with Dialectical Behavior Therapy (DBT), and if yes, how do you use it?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
13) What financial arrangements do you participate in? (what insurance, cash, check, credit cards, etc.)
___________________________________________________________________________________
________________________________________________________________________
14) Do you have a sliding scale?
_________________________________________________
15) Do you do family therapy? _________________
16) Do you do groups, and if so what kind?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
17) Briefly discuss your training:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
18) How committed are you to maintaining a counselor/client relationship with the BPD? If the BPD went into the hospital, self-mutilated or attempted suicide, would you drop him/her as a client?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
19) Please leave any message you feel is important, particularly for patients and family members and why they would benefit from developing a professional relationship with you.
1) What is your degree? ________________ (psychiatrist, physician, psychologist, M.S.W., LCSW, etc.)
2) How long have you been in practice? ___________________
3) How do you get professional satisfaction treating patients with the borderline personality disorder (BPD)?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
4) Do you find BPD patients difficult to treat, and if yes, how do you handle this?
____________________________________________________________________________________
____________________________________________________________________________________
5) How do you approach treating friends or loved ones of people with the BPD? ____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
6) How many borderlines have you treated? _________________________
7) How many borderlines are currently on your case load?
___________________________
8) Do you believe the BPD has a strong medical basis?
_____________________________________________________________________________________
_____________________________________________________________________________________
9) What do you believe is the prognosis for the BPD?
_____________________________________________________________________________________
_____________________________________________________________________________________
10) How do you handle self-mutilatory borderlines?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
11) If you prescribe medications, how familiar are you with the medical research on treatment?
_____________________________________________________________________________________________________________
____________________________________________________________________________________
12) For therapists: Are you familiar with Dialectical Behavior Therapy (DBT), and if yes, how do you use it?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
13) What financial arrangements do you participate in? (what insurance, cash, check, credit cards, etc.)
___________________________________________________________________________________
________________________________________________________________________
14) Do you have a sliding scale?
_________________________________________________
15) Do you do family therapy? _________________
16) Do you do groups, and if so what kind?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
17) Briefly discuss your training:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
18) How committed are you to maintaining a counselor/client relationship with the BPD? If the BPD went into the hospital, self-mutilated or attempted suicide, would you drop him/her as a client?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
19) Please leave any message you feel is important, particularly for patients and family members and why they would benefit from developing a professional relationship with you.
Borderline Personality Disorder Sanctuary
http://www.mhsanctuary.com/borderline
You may freely copy and distribute.
Tim Pheil LPN