Borderline Personality Disorder (BPD) Checklist

Streamline your Borderline Personality Disorder management with our comprehensive BPD Checklist Template for organized and effective tracking of tasks and goals.

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Written by
Liliana Braun
Liliana Braun
Reviewed by
Liliana Braun

What is a BPD Checklist?

A BPD template, also known as a Borderline Personality Disorder template, stands as a crucial and dynamic tool within the arsenal of healthcare professionals, systematically employed to assess and monitor the multifaceted symptoms associated with Borderline Personality Disorder (BPD). This comprehensive template provides a structured and methodical framework, enabling healthcare practitioners to conduct thorough evaluations across various dimensions of BPD. 

At its core, the BPD template serves as a roadmap for healthcare professionals, guiding them through a detailed analysis of critical aspects such as emotional dysregulation, impulsivity, interpersonal relationship challenges, and self-image disturbances. By offering a systematic approach to symptom assessment, this template empowers healthcare professionals to understand the nuanced manifestations of BPD in each individual. 

The structured nature of the BPD template facilitates a holistic evaluation that goes beyond mere symptom identification. It allows healthcare professionals to discern patterns, assess the severity of symptoms, and track the progression of BPD over time. Additionally, the template's adaptability ensures that it can be customized to suit each patient's specific needs and unique presentation, fostering a personalized and targeted approach to intervention. 

Furthermore, the BPD template serves as a valuable communication tool, fostering collaboration among healthcare professionals involved in caring for individuals with BPD. It enables a standardized and systematic exchange of information, enhancing the continuity of care and promoting a cohesive and integrated approach to treatment.

Downloadable BPD Checklist PDF

Access our free BPD Checklist PDF to manage Borderline Personality Disorder

How does it work?

Steps involved with using a Printable BPD Checklist Template:

  1. Gather patient information: Before starting the BPD assessment, review the patient's medical history, including current medications, allergies, and past mental health diagnoses. This information provides context for the examiner's observations.
  2. Assess emotional dysregulation: Evaluate the patient's tendency to experience intense and unstable emotions, such as anger, sadness, and fear. Observe for mood swings, emotional reactivity, and difficulty managing emotions.
  3. Assess impulsivity: Evaluate the patient's tendency to engage in impulsive behaviors without considering the consequences. This may include risky sexual behavior, substance abuse, reckless driving, or sudden spending sprees.
  4. Assess interpersonal difficulties: Evaluate the patient's unstable and intense relationship patterns. This may include idealizing others, devaluing others, and difficulty maintaining stable relationships.
  5. Assess self-image disturbances: Evaluate the patient's unstable self-image and sense of self. This may include a distorted body image, frequent changes in self-perception, and feelings of emptiness or worthlessness.
  6. Document findings: Clearly document all observations and findings in the BPD template. This documentation serves as a record of the patient's BPD symptoms and facilitates comparisons over time.
  7. Interpret findings: Analyze the collected information to identify the core symptoms of BPD and assess the severity of the disorder. This interpretation guides further diagnostic testing and treatment planning.
  8. Discuss findings with the patient: Communicate the findings of the BPD assessment to the patient in a clear and understandable manner. This discussion helps educate the patient about their BPD symptoms and address any concerns.
  9. Develop a treatment plan: Based on the assessment findings and patient's needs, develop a comprehensive treatment plan that may include psychotherapy, medications, and lifestyle modifications.
  10. Monitor progress: Regularly monitor the patient's progress and adjust the treatment plan as needed. This ensures that the patient is receiving appropriate care and that their BPD symptoms are managed effectively.

BPD Checklist example (sample)

The BPD Template, functions as an invaluable tool within the mental health landscape, offering a systematic approach to assess and manage Borderline Personality Disorder (BPD). 

Serving as a comprehensive documentation tool, the BPD Template facilitates clear and seamless communication among individuals with BPD, their support networks, mental health professionals, and relevant stakeholders involved in the nuanced dynamics of BPD care. 

With its structured framework, the BPD Template ensures the efficient sharing and comprehension of critical information related to the assessment and management of BPD. By encapsulating key dimensions such as emotional regulation, interpersonal dynamics, and self-perception, this template provides a holistic understanding of the individual's BPD experience.

Download our free BPD Checklist example PDF

BPD Checklist example

When would you use this Template?

  • Initial assessment: When a patient first presents with symptoms that suggest BPD, a BPD template can be used to conduct a comprehensive initial assessment. This helps gather detailed information about the patient's symptoms, patterns of behavior, and personal history, providing a strong foundation for diagnosis and treatment planning.
  • Monitoring symptom severity: For patients with a diagnosed BPD, BPD templates can be used regularly to monitor the severity of their symptoms. This allows healthcare professionals to track changes in the patient's emotional regulation, impulsivity, interpersonal relationships, and self-image, which helps assess the effectiveness of treatment and make necessary adjustments.
  • Guiding treatment decisions: The information gathered from BPD templates can inform treatment decisions and tailor interventions to each patient's specific needs. By identifying the predominant BPD symptoms and understanding their impact on the patient's life, healthcare professionals can choose appropriate psychotherapy techniques, consider medication options, and recommend lifestyle modifications.
  • Evaluating treatment effectiveness: Regularly using BPD templates allows healthcare professionals to evaluate the effectiveness of treatment over time. By comparing the patient's symptoms at different points in time, they can assess whether the treatment plan is working effectively, identify areas where progress is needed, and make adjustments accordingly.
  • Communicating with other providers: BPD templates can facilitate communication and collaboration between healthcare professionals involved in the patient's care. By sharing the documented assessment findings and treatment progress, providers can ensure continuity of care and that the patient receives consistent and informed treatment.

What do the results mean?

Common results of a Free BPD Checklist Template and their meanings include:

Emotional dysregulation

Emotional dysregulation manifests through frequent and sudden changes in mood, encompassing rapid shifts between anger, sadness, fear, and joy. Individuals may experience mood swings, moving from intense happiness or euphoria to deep sadness or despair. Emotional reactivity is heightened sensitivity to external stimuli, resulting in exaggerated emotional responses. Managing emotions becomes challenging, with individuals struggling to control and express their feelings in a healthy and appropriate manner. 


Impulsivity involves engaging in risky behaviors without considering consequences, such as substance abuse, reckless driving, or unprotected sex. Poor impulse control leads to difficulty resisting urges or temptations, even when aware of negative consequences. 

Making impulsive decisions occurs without careful consideration or planning, often resulting in regretful choices. Financial difficulties may arise due to impulsive spending or poor financial management. 

Interpersonal difficulties

Interpersonal challenges include unstable relationships characterized by intense and chaotic dynamics, frequent conflicts, breakups, and makeups. Idealization and devaluation patterns involve initially idealizing others in relationships, followed by devaluation and criticism as the relationship progresses.

Difficulty maintaining stable and healthy relationships stems from emotional volatility and impulsive behaviors. A fear of abandonment may lead to intense anxiety about being left alone, resulting in clingy or dependent behavior. 

Self-Image disturbances

Disturbances in self-image include distorted body image, with individuals having an unrealistic or distorted perception of their physical appearance. Rapid and significant changes in self-perception and self-worth are common. 

Feelings of emptiness or worthlessness lead to a sense of hollowness, low self-esteem, and self-destructive behaviors. Identity disturbance is characterized by a struggle to maintain a consistent sense of self, confusing personal identity and goals.

Why use Carepatron as your BPD Checklist app?

In the realm of mental health care, particularly in the nuanced field of Borderline Personality Disorder (BPD) management, precision and efficiency are paramount. Carepatron emerges as the optimal choice for your BPD Template application, offering a streamlined and user-friendly platform designed to elevate the efficiency of healthcare professionals. 

Boasting an intuitive design, Carepatron simplifies the process for healthcare professionals by providing easily downloadable BPD Template resources. The BPD Template app from Carepatron is a transformative tool, ensuring accessibility and ease in developing personalized checklists tailored to the specific needs of individuals navigating the complexities of BPD. 

Carepatron’s versatility accommodates the diverse needs associated with individual experiences, family dynamics, and community factors, ensuring a comprehensive and integrated approach to BPD care. Carepatron stands as a reliable ally for healthcare professionals seeking precision and efficiency in the intricate landscape of Borderline Personality Disorder management.

Mental Health Software Benefit


Biskin, R. S., & Paris, J. (2012). Diagnosing borderline personality disorder. Canadian Medical Association Journal, 184(16), 1789–1794.

Chapman, J., Jamil, R. T., & Fleisher, C. (2022, June 2). Borderline Personality Disorder. National Library of Medicine; StatPearls Publishing.

How do you create a BPD Checklist?
How do you create a BPD Checklist?

Commonly asked questions

How do you create a BPD Checklist?

Carepatron has a ready-to-download and use BPD checklist template for your convenience.

When are BPD Checklists used?

BPD Checklists are used when healthcare professionals need to systematically assess and monitor the symptoms of borderline personality disorder

How are the BPD Checklists used?

Healthcare professionals use BPD Checklists to evaluate various aspects of BPD, including emotional dysregulation, impulsivity, interpersonal difficulties, and self-image disturbances.

Who creates a BPD Checklist?

Healthcare professionals can create BPD Checklists, organizations that develop standardized assessments, or software developers such as Carepatron.

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