Aim
Historically, the research and clinical focus for the treatment of personality disorder has been oriented to the consumer and clinician experience. However, mental illness is a challenge for the whole family system. Families and carers of people with personality disorder have reported experiencing significant levels of burden and support needs. Families have expressed the importance of support options to enhance their understanding, facilitate acceptance, and navigate their burden and grief.
Method
This review outlines the current state of knowledge in the experience of families and carers of people with personality disorder and their support needs, and provides recommendations for future developments.
Results
Data from the Project Air Strategy laboratory with 287 carers of a person with lived experience of personality disorder found significant levels of burden, grief and psychological distress. A follow up study of 280 carers found that those with higher levels of emotional overinvolvement also experience higher burden and mental health distress. Group support for families and carers focusing on psychoeducation and relationship patterns found improvements in family empowerment, adjustment and expressed emotion. Recent advancements in the field have allowed systematic reviews to identify common themes across such support interventions, including the importance of psychoeducation, skills training and peer support (e.g., Guillen et al., 2020; Sutherland et al., 2019). However, further developments are required to expand the reach of support options for carers of people with personality disorder. This may include understanding carer preference, optimal modality and duration of support interventions, essential components, and how support options improve broader family relationships and outomes.
Conclusion
To date, the research and support opportunities available to families and carers have focused on localised approaches. Whilst recent advancements in understanding the experience of families and carers has allowed further insights into the unique support needs of this group, future developments are needed to expand the reach to families and carers globally.