Advancing the treatment of long-lasting borderline personality disorder : a feasibility and acceptability study of an expanded DBT-based skills intervention
Soler, Joaquim (Institut d'Investigació Biomèdica Sant Pau)
Casellas-Pujol, Elisabet (Institut d'Investigació Biomèdica Sant Pau)
Pascual Mateos, Juan Carlos (Institut d'Investigació Biomèdica Sant Pau)
Schmidt, Carlos (Institut d'Investigació Biomèdica Sant Pau)
Dominguez-Clave, Elisabet (Institut d'Investigació Biomèdica Sant Pau)
Cebolla Marti, Ausias (Universidad de Valencia. Departamento de Personalidad, Evaluación y Tratamientos Psicológicos)
Alvear Morón, David (Universidad del País Vasco)
Muro Rodríguez, Anna (Universitat Autònoma de Barcelona. Departament de Psicologia Bàsica, Evolutiva i de l'Educació)
Elices, M. (Institut d'Investigació Biomèdica Sant Pau)

Date:	2022
Abstract:	Long-term follow-up studies in patients with borderline personality disorder (BPD) consistently show persistent impairment in psychosocial adjustment, although symptoms tend to decrease over time. Consequently, it might be better to deemphasize symptom-oriented interventions and instead promote interventions that incorporate patient perspectives on recovery. In this study we aimed to examine the feasibility and acceptability of a novel intervention (dialectical behavioral therapy combined with positive psychology and contextual-based skills) in the clinical treatment of long-lasting BPD difficulties. This was a qualitative study. We developed an initial 8-week group intervention for long-lasting BPD. Upon completion of the 8-week program, the participants were asked to participate in a group discussion to provide feedback. Based on that feedback, the intervention protocol was modified and then offered to a second group of patients, who also provided feedback. The protocol was revised again and administered to a third group. A total of 32 patients participated in the group interventions; of these, 20 provided feedback in the qualitative study. The main outcome measure was acceptability. The following overarching themes emerged from the group interviews: helpful, unhelpful and neutral practices; internal/external barriers; facilitators; and effects. Participants reported difficulties in imagining an optimal future and self-compassion. By contrast, positive skills were associated with an increase in positive emotions. The main internal barrier was facing difficult emotions. The main external barriers were language-related issues. The group format was perceived as a facilitator to success. Dropout rates, which were assessed as an additional measure of acceptability, decreased substantially in each successive group, from 60 to 40% and finally 20%. The intervention was feasible to implement in the clinical setting and participants rated the final set of skills highly. Most of the skills were considered useful. Participant feedback was invaluable to improve the intervention, as evidenced by the large increase in the retention rate from 40 to 80%. Randomized clinical trials are needed to test the efficacy of this intervention in promoting well-being in participants with long-lasting BPD.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Borderline personality disorder ; Long-lasting BPD ; Feasibility ; Acceptability ; Skills training ; Positive psychology ; Dialectical behavior therapy ; Contextual approach
Published in:	Borderline personality disorder and emotion dysregulation, Vol. 9 (december 2022) , ISSN 2051-6673

DOI: 10.1186/s40479-022-00204-x
PMID: 36503564

14 p, 1016.2 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles