A Guide to General Psychiatric Management
Developed to connect emotions and behaviors to interpersonal problems, GPM can be learned easily to help borderline personality disorder patients
July 19, 2022
General psychiatric management (GPM), also known as good psychiatric management, is a treatment for borderline personality disorder (BPD).
BPD is a complex condition that can make everything about a person’s life feel unstable, including their emotions, sense of self, and relationships. While BPD is a serious illness, it is also highly treatable.
As a generalist approach, GPM is easily learned by most clinicians and effective for treating most BPD patients.
At the heart of GPM is the idea that most people with BPD will get better over time, and lasting change does not require intensive treatment.
GPM therapists focus on patients’ hypersensitivity to what happens in relationships.
Clinicians connect the patient’s emotions and behaviors to relationship stressors. They incorporate practical problem-solving (case management), education, and realistic goal setting into treatment.
GPM is a clinical management approach that can be practiced by primary care doctors, nurse practitioners, and other mental health professionals who are not therapists. It can be used to guide treatment in inpatient units, emergency departments, and outpatient settings.
With this flexibility, more health professionals can become qualified to help more people with BPD receive the help they need.
Keep Reading To Learn
- Why GPM was developed
- How GPM helps people with BPD
- Who can provide GPM—and how to find care
Understanding General Psychiatric Management
People with borderline personality disorder make up about 1.6% of the general population. In clinical settings, 20% of patients have BPD.
There are many effective treatments for borderline personality disorder. These include dialectical behavior therapy (DBT), mentalization-based treatment (MBT), schema-focused therapy (SFT), and transference-focused psychotherapy (TFP). These treatments generally take years to master and are only offered by therapists or treatment programs specializing in BPD.
Given the high number of BPD patients who seek care, most clinicians will treat people with the condition at some point. However, many mental health professionals do not have the resources to pursue intensive training and many patients cannot access specialized treatments.
As a result, people with BPD do not have enough options for treatment and they may receive inadequate and misguided care.
General psychiatric management is founded on the idea that people with BPD should expect their clinicians to be trained credibly to treat the disorder that causes the greatest degree of risk and disability for the patient.
Only some patients need specialized treatment. Good enough, informed, and personalized care can help most people with BPD lead healthy and productive lives. This is what all patients should expect clinicians to know at a basic level.
GPM addresses this need for basic BPD treatment partly because it is easily learned.
Informed by research and clinical expertise, GPM training is delivered in a one-day course for mental health professionals already in practice.
The late John Gunderson, MD, developed GPM. Gunderson, a professor at Harvard Medical School and psychiatrist at McLean Hospital, was a pioneer in the diagnosis, treatment, and research of borderline personality disorder.
In the last decade of his career, Gunderson worked alongside Lois W. Choi-Kain, MD, MEd, to develop a formalized training course for GPM.
They believed that most clinicians could learn to treat BPD using GPM techniques that could be taught efficiently and delivered to patients at less cost than specialized BPD treatments.
Now, GPM is increasingly being integrated into psychiatric training as the first-line treatment for BPD.