The type of therapeutic communication I would use for this patient is using recognition, paraphrasing her comments, reflecting on her thoughts,...
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The type of therapeutic communication I would use for this patient

is using recognition, paraphrasing her comments, reflecting on her thoughts, acknowledging her, and showing acceptance of what she is saying (registerednuring.org). I would use Schema-focused therapy, more flexible and attuned therapy to a person's emotions (verywellmind.com).  This is a more prolonged treatment, but it focuses that BPD is based on maladaptive thoughts or behaviors. The benefit would be to use different techniques like guided imagery, assertiveness training, and role- playing to confront daily experiences and past traumas (health.havard.edu). 
            I will begin my assessment by determining if the patient is a suicide risk. Clients with personality disorders are known to have a higher death rate, including suicide (nurselabs.com). Common co-morbidities include mood disorder, anxiety, panic disorder, alcohol or substance abuse, eating disorders, and gender (psychiatrictimes.com). A proper nursing diagnosis for this patient would be defensive coping related to difficulty with relationships, as evidence by the inability to accept blame for own behavior. I would establish a therapeutic nurse-client relationship, assess the presence of positive coping skills and inner strengths, and provide a quiet, non-stimulating environment (Nursing Diagnosis Handbook edition 11). I would also recommend for her provider to change her medications. I would suggest her psychiatrist, social worker, and a nurse for the interdisciplinary referrals.  
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