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Many patients are not considered ready to engage in specialist treatments and remain in CMHTs without any clear focus or structure to their treatment, which is unsatisfactory for patients, clinicians and services. We present a fictional case and synthesise available literature and lived experience to explore readiness and ways to promote it. We highlight relevant issues for trainees to consider in practice. Patients with EUPD who have not received specialist treatment can be considered in terms of the transtheoretical model's stages of change. Identifying a patient's stage can help guide how to increase readiness for referral and decide when to refer. Interventions available to all healthcare professionals which may promote readiness include: psychoeducation, personal formulations, crisis planning, goal-setting, peer support, distress tolerance skills, motivational interviewing and mindfulness.<\/jats:p>","DOI":"10.1192\/bjb.2020.48","type":"journal-article","created":{"date-parts":[[2020,6,10]],"date-time":"2020-06-10T08:41:20Z","timestamp":1591778480000},"page":"52-58","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":11,"title":["Referral of patients with emotionally unstable personality disorder for specialist psychological therapy: why, when and how?"],"prefix":"10.1192","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5095-4150","authenticated-orcid":false,"given":"Matthew","family":"Roughley","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Maguire","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Wood","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tennyson","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2020,6,10]]},"reference":[{"key":"S2056469420000480_ref22","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1108\/13619321211287229","article-title":"Engaging clients with personality disorder in treatment","volume":"17","author":"Huband","year":"2012","journal-title":"Mental Health Rev J"},{"key":"S2056469420000480_ref24","doi-asserted-by":"publisher","DOI":"10.1037\/10226-016"},{"key":"S2056469420000480_ref26","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-14-50"},{"key":"S2056469420000480_ref1","first-page":"1","article-title":"The prevalence of personality disorder, its comorbidity with mental state disorders, and its clinical significance in community mental health teams","author":"Newton-Howes","year":"2009","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"S2056469420000480_ref32","doi-asserted-by":"publisher","DOI":"10.1007\/s10608-006-9016-y"},{"key":"S2056469420000480_ref17","volume-title":"Meeting the Challenge, Making a Difference: Working Effectively to Support People with Personality Disorder in the Community","author":"Wood","year":"2014"},{"key":"S2056469420000480_ref20","volume-title":"Refocusing the Care Programme Approach","year":"2008"},{"key":"S2056469420000480_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2011.12.002"},{"key":"S2056469420000480_ref10","doi-asserted-by":"publisher","DOI":"10.1037\/h0088437"},{"key":"S2056469420000480_ref19","volume-title":"Position Statement PS01\/20: Services for People Diagnosable with Personality Disorder","year":"2020"},{"key":"S2056469420000480_ref6","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1108\/MHRJ-04-2014-0012","article-title":"Organisational effectiveness and personality disorder","volume":"20","author":"Carter","year":"2015","journal-title":"Mental Health Rev J"},{"key":"S2056469420000480_ref15","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1974.01760110049005"},{"key":"S2056469420000480_ref14","first-page":"7","article-title":"An overview of countertransference with borderline patients","volume":"2","author":"Gabbard","year":"1993","journal-title":"J Psychother Pract Res"},{"key":"S2056469420000480_ref33","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0b013e3181b97343"},{"key":"S2056469420000480_ref18","doi-asserted-by":"publisher","DOI":"10.1192\/bja.2018.29"},{"key":"S2056469420000480_ref27","volume-title":"Cognitive\u2013Behavioral Treatment of Borderline Personality Disorder","author":"Linehan","year":"1993"},{"key":"S2056469420000480_ref34","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-09593-6"},{"key":"S2056469420000480_ref16","doi-asserted-by":"publisher","DOI":"10.1192\/bja.2018.63"},{"key":"S2056469420000480_ref7","unstructured":"7 National Institute for Health and Care Excellence. 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