Growing recognition that borderline personality disorder (BPD) and its features emerge in adolescence has prompted the development of guidelines to assist with assessment and management in this population. An environmental scan identified 11 guidelines for BPD and its features that provided recommendations applicable to adolescent populations and were available in or could be translated to English. Seven were specific to BPD and four were related to self-harm. Of the seven guidelines specific to BPD, all covered the assessment of BPD, while only six addressed the treatment of BPD. Guidelines for BPD in adolescents recommended the use of a clinical semi-structured interview for assessment; involvement of family members and carers; inclusion of psychoeducation; psychotherapies as the primary treatment; and if required, short-term medication. Of the six guidelines providing treatment guidance, three recommended outpatient care where possible. The remaining three guidelines did not provide recommendations about treatment setting. Guidelines for the management of self-harm in adolescents were similar, emphasising the importance of assessment, prioritising psychotherapy as the main form of treatment, and the use of screening tools to identify at-risk adolescents. Several guidelines exist for the assessment and management of BPD and self-harm in adolescents. This review is the first to show how recommendations converge across guidelines, providing clinicians with guidance to support family-inclusive care and evidence-based treatment planning. However, the evidence underlying the recommendations is largely based on small samples and cross-sectional designs, emphasising the need for larger studies to strengthen the evidence base.
Louise et al. (2026) studied this question.