BORDERLINE PERSONALI TY 53 5. Assign Reading on Borderline Personality Disorder (5) A. The client was asked to read selected sections of books or manuals that reinforce therapeutic interventions. B. Portions of Skills Training Manual for Treating Borderline Personality Disorder (Linehan) were assigned to the client. C. The client has read assigned information from books or manuals, and key concepts were reinforced. D. The client has not read assigned portions of b ooks or manuals that reinforce therapeutic interventions and was redirected to do so. 6. Solicit Agreement for DBT (6) A. An agreement was solicited from the client to work collaboratively within the parameters of the DBT approach. B. A written agreemen t was developed with the client to work collaboratively within the parameters of the DBT approach. C. The client has agreed to work within the DBT approach to overcome the behaviors, emotions, and cognitions that have been identified as causing problems i n his/her life. D. The client was reinforced for his/her commitment to working within the DBT program. E. The client has not agreed to work within the DBT program and was referred back to “Treatment as Usual. ” 7. Explore Self-Mutilating Behavior (7) A. The client's history and nature of self-mutilating behavior were explored thoroughly. B. The client recalled a pattern of self-mutilating behavior that has dated back several years. C. The client's self-mutilating behavior was identified as being associ ated with feelings of depression, fear, and anger, as well as a lack of self-identity. 8. Assess Suicidal Behavior (8) A. The client's history and current status regarding suicidal gestures were assessed. B. The secondary gain associated with suicidal g estures was identified. C. Triggers for suicidal thoughts were identified, and alternative responses to these trigger situations were proposed. 9. Arrange Hospitalization (9) A. As the client was judged to be harmful of self, arrangements were made for voluntary psychiatric hospitalization. B. As the client refused a necessary psychiatric hospitalization, the proper steps to involuntary hospitalize the client were initiated. C. The client has been psychiatrically hospitalized. D. Ongoing contact with the psychiatric hospital has been maintained in order to coordinate the most helpful treatment while in the hospital. 10. Refer to Emergency Helpline (10) A. The client was provided with an emergency helpline telephone number that is available 24 hours a day. 