Avoiding the Borderline Personality Disorder Client

What can you do as a legal nurse consultant to avoid the borderline personality disorder client from hell? In part 1, I shared tips for detecting the borderline personality disorder client.

The first rule of dealing with this kind of client is not to take cases from him or her in the first place.

When you are screening new clients, make sure you ask them some crucial questions to help identify the client from hell in advance. In addition to the obvious intake questions, you should also listen for any complaints about services obtained from other legal nurse consultants. Ask why your new client stopped doing business with them.

Ask whether there were ever any lawsuits or arbitrations with legal nurse consultants or other helpers. And don’t agree to take on a client until after the screening interview. If screening raises huge red flags, refuse to engage with the client by telling her that her case sounds quite involved and you realize your schedule won’t allow you to give it the attention it deserves. This tells her that it is YOU who is not worthy of this case. And don’t let her convince you otherwise.

If you have a client who has gotten through your early warning system, and then becomes impossible or unreasonable, you must continue to draw firm boundaries

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Your borderline personality disorder client does not have them. Give the client choices within those boundaries. Keep good notes and telephone logs and ask the client to sign any changes to agreements between you – now, not later.

This process of setting boundaries will go around several times much like giving yourself a shampoo: apply shampoo, lather, rinse, repeat. But don’t expect the borderline personality disorder client to learn to set the boundaries; it will always fall to you.

When the relationship sours to the point of near-constant frustration, you have to ask yourself some tough questions:

• How important is this client to my bottom line?
• How much am I willing to endure in an effort to provide good service?
• How much do I value my sanity and peace of mind?
• How quickly can I extricate myself?

The answers to those questions will often determine whether the time has come to “fire” the borderline personality disorder client.

This is the time to terminate the client with some grace. After all, you want her to go away, but you don’t want her to go away mad. Consider having a face-to-face meeting and using this script: “You know, we’ve worked together for a while now, but I sense we just can’t provide you with the kind of service you really want. How would you like me to close your file? Would you like me to recommend someone who might be better able to serve you?” There will be anger, blaming and pleading. The energy you invest in this step will help you recognize the next “nightmare client.”

Leslie Durr PhD RN PMHCNS-BCprepared this guest post. She is in private practice providing psychotherapy and consultation in Charlottesville, Virginia. She earned her PhD in Nursing systems Administration from Virginia Commonwealth and her M.S. in Nursing from Hunter College of the City University of New York. She is board certified in Child & Adolescent Psychiatric/Mental Health Nursing.