Working with parents with borderline personality disorder in youth protection services: When suffering is combined with dismay
About 22.5% of mothers of children followed by Youth Protection Services have a known or probable borderline personality disorder. There are however very little information on the challenges faced by psychosocial workers who work with this clientele in the context of a protection mandate. This qualitative study focused on this particular issue. Data was collected during six focus groups in which 104 case workers from Centre jeunesse de Montréal-Institut universitaire participated. The results suggest that they perceive their interventions with these families to be subject to a set of contingencies that make their work particularly complex and demanding. Three main themes in relation to their concerns and challenges regarding their practice and in relation to their needs were highlighted. The first theme regards intervention difficulties related to the interpersonal context. The analyses show for example that trying to reconcile child protection and support for parents, or to talk to the children about their parents’ mental disorder prove to be particularly difficult. The second theme related to the context of their working environment concerns their perceptions of the contingencies associated with the internal organization of services and with the collaboration with partners (judiciary milieu and adult psychiatry). The impact of the interpersonal and environmental contexts on the caseworkers constitutes the third theme. Participants suggested that the management of families impacted by this mental disorder puts an important strain on them, both emotionally and cognitively. Finally, this article highlights the importance of addressing the daily challenges faced by those working with families affected by borderline personality disorder and presents some organizational and clinical recommendations in order to better support the workers.