Borderline Personality Disorder Assessment: The Process for Diagnosis

Considerations for BPD assessment

Verywell / Laura Porter

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The signs and symptoms of borderline personality disorder (BPD) often overlap those of other mental health disorders such as anxiety and depression. This often makes accurate diagnosis difficult—but crucial for effective treatment and long-term mental health. Follow the steps below to get on track toward an accurate diagnosis.

What Is Borderline Personality Disorder

BPD is "a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts," according to DSM-5.

Find a Mental Health Professional

The first step toward an accurate diagnosis is finding a qualified mental health professional. Here are a few types of healthcare providers who can do BPD assessments:

  • Clinical psychologist (PhD/PsyD)
  • Licensed clinical professional counselor (LCPC) 
  • Licensed clinical social worker (LSCW)
  • Licensed independent social worker (LISW)
  • Licensed mental health counselor (LMHC)
  • Licensed professional counselor (LPC)
  • Psychiatric nurse practitioner (PMHNP)
  • Psychiatrist (MD)

Choose an independently operating therapist who:

Make a note of all your questions before you contact possible providers so you remember to ask them.

If you have health insurance, ask your insurance company to recommend some nearby in-network mental health professionals with the expertise you're seeking. If you don't have health insurance, you may qualify for public assistance programs and services through your state or region's department of mental health or social services.

Schedule an Assessment

Once you have a short list of BPD therapists who meet your baseline requirements, call to schedule each for an initial consultation. Many mental health professionals offer free, brief consultations over the phone.

Talk with the therapist about:

Why you're interested in BPD assessment and treatment

  • Your symptoms
  • Your initial questions
  • Charges and billing procedures
  • Insurance coverage

Speak to a few therapists, find the one you feel most comfortable with, and schedule an assessment.

Start the Assessment Process

When you arrive for your first therapy session, it's normal to feel nervous and uncomfortable, particularly if you are new to therapy. Keep in mind, however, that the more direct and honest you are during your BPD assessment and possible treatment, the more you will get out of it.

Your BPD assessment may take one or several sessions. Your therapist will tell you how long the assessment will take and the types of tests or interviews to expect.

Providers use various tools to conduct assessments. Generally, a therapist will ask questions about your current and past symptoms, family and work history, and current life situation. Some therapists might also give you a short questionnaire and/or psychological test.

Borderline Personality Disorder Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor's appointment.

Mind Doc Guide

Get a Diagnosis

You'll probably receive a diagnosis soon after your BPD assessment. If your therapist needs more information, however, they may refer you to a specialist or your primary care doctor for further assessment. Your therapist might desire a second opinion or refer you to a specialist to rule out underlying conditions.

More likely, however, is that you'll receive a diagnosis at the end of your BPD assessment. Your therapist discuss your symptoms with you some more and recommend treatment options.

Your therapist will provide some or all of your treatment, depending on their qualifications and state regulations. If necessary, they may refer you for part of your therapy to another mental health professional with special expertise or the ability to prescribe medication.

A Word From Verywell

BPD can be difficult to assess and diagnose for the healthcare provider. Many of the symptoms overlap with other mood disorders, and BPD doesn’t look the same in everyone, However, an accurate diagnosis is crucial for getting the right treatment and improving its prognosis.

1 Source
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). doi:10.1176/appi.books.9780890425596

Additional Reading
  • Groth-Marnat, G. Handbook of Psychological Assessment. New York: John Wiley and Sons, 2003.
  • National Education Alliance for Borderline Personality Disorder (2016). About BPD.

By Kristalyn Salters-Pedneault, PhD
 Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University.