Healthy habits worksheet
If you’re a therapist looking for borderline personality disorder worksheets for clients, you’re in the right place.
This guide to borderline personality disorder worksheets (BPD worksheets) gives mental health therapists a brief overview of the condition and examples of therapeutic interventions.
We’ve also provided tips for how to use the free downloadable borderline personality disorder self-help worksheets.
What is borderline personality disorder?
Borderline personality disorder (BPD) is a mental health condition that impacts emotional regulation.
The key characteristics of BPD include:
Intense and variable mood swings, including depression, irritability, and anxiety, lasting hours or days
Impulsive behaviors that may be risky, like spending, unprotected sex, substance use, binge eating, and unsafe driving
Distorted self-image, impacting mood, goals, perspective, and relationships
Intense reactions to stressors
A pattern of intense and unstable relationships with family, friends, and others, which may alternate between idealization (“They’re a dream”) and devaluation (“They’ve ruined my life”)—this is also known as splitting
Efforts to avoid real or perceived abandonment by friends and family
Self-harming behaviors
Recurrent suicidal ideation or threats of suicidal behaviors
Chronic feelings of emptiness or boredom
Inappropriate, intense anger or difficulty controlling anger, with feelings of guilt and shame that may follow
Dissociation, which is when a person feels outside of or disconnected from their body, stress-related paranoia, or feelings of unreality
Symptoms vary from person to person and may interplay with other mental health conditions, like mood disorders and trauma.
Risk factors for borderline personality disorder
According to the National Institute of Mental Health, research suggests that genetic, social, and environmental factors may influence the likelihood of developing BPD, including:
A family history of the condition: While no specific gene has been identified that causes BPD, a family history of the condition may increase the likelihood of developing it.
Brain structure: People with BPD may have functional changes in areas of the brain that control decision-making, judgment, and emotional regulation.
Experiencing trauma: This includes unsafe relationships and childhood experiences of abandonment, neglect, abuse, or hardship.
Therapy activities for borderline personality disorder
Treatment for borderline personality disorder includes psychotherapy, medications, and sometimes hospitalization when safety is an issue.
Therapy activities for BPD may involve working individually with a therapist who uses a combination of BPD worksheets and a didactic approach involving:
Identifying triggers and patterns
Learning to recognize the specific situations, relationships, or emotions that trigger intense mood swings, fear of abandonment, and impulsive behaviors can help individuals anticipate their reactions and implement coping strategies before emotions become overwhelming.
Strengthening emotional regulation skills
Identifying emotions and moods and using emotion trackers are important aspects of emotional regulation.
Dialectical behavioral therapy (DBT)
DBT strengthens emotional regulation and distress tolerance skills and improves interpersonal communication.
DBT tools include:
Mindfulness skills
For example, this includes the wise mind exercise that focuses on responding from a mindful rather than emotional place.
REST: Helps with overwhelming emotions by providing structure. The acronym stands for relax, evaluate, set an intention, and take action.
Self-soothing: Using senses with prompts like smell, vision, hearing, touch, and taste to calm the nervous system.
IMPROVE: Helps to replace a distressing environment with a calmer one. The acronym stands for imagery, meaning, prayer, relaxation, focusing on one thing, vacation, and encouragement.
ACCEPTS: This tool helps to manage stress and regulate difficult emotions. The acronym stands for activities, contributing, comparisons, emotions, pushing away, thoughts, and sensations.
TIP: Calms an overwhelmed body using temperature, intense exercise, and paced breathing techniques.
Emotional regulation skills
STOP: Involves stopping, taking a step back, observing thoughts and feelings, and proceeding mindfully.
Opposite action: Encourages an alternative response that acts from a place of mindfulness rather than reactiveness.
PLEASE skill: Emphasizes healthy habits to improve emotional regulation by attending to physical illness, eating nutritiously, avoiding substances, getting enough sleep, and exercising regularly.
Interpersonal effectiveness skills
DEAR MAN: This tool helps you communicate assertively. It involves describing the situation, expressing feelings, using assertive language, reinforcing boundaries, being mindful of tone of voice, appearing confident with a neutral but assertive posture, and being open to negotiation.
GIVE: Improves communication and promotes healthy interactions by being gentle, interested, validating, and easy.
FAST skill: Helps to maintain self-respect while honestly expressing oneself. The acronym stands for be fair, don't over-apologize, stick to your values, and be truthful.
THINK skill: Deals with unhelpful emotions toward others through empathy and kindness. The acronym stands for think, have empathy, consider alternative interpretations, mindfully notice, and kindness.
Cognitive behavioral therapy (CBT)
BPD therapy worksheets may also include CBT exercises, such as identifying negative core beliefs and unhelpful thoughts and using cognitive restructuring to create more adaptive thoughts and behaviors.
Therapists may also use thought records and cognitive distortion worksheets to improve awareness of unhelpful thoughts and their impacts.
We’ve included these activities in our free downloadable BPD worksheet.
How to use borderline personality disorder worksheets
Therapists can use the borderline personality disorder worksheets in several ways.
For example, use the borderline personality disorder worksheets in session to illustrate the activities and outline a multifaceted treatment plan.
The BPD worksheets can also be used to provide psychoeducation about the mental health condition and coping strategies. It can empower clients to identify their stressors and preferred coping strategies.
The borderline personality disorder worksheets can also be used as handouts for clients to practice the skills between sessions and then debrief at their next therapy appointment.
Sources
National Institute of Mental Health. (2024). Borderline Personality Disorder.
John Hopkins Medicine. (n.d.) What is borderline personality disorder?
National Alliance on Mental Illness. (2023). Borderline Personality Disorder
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