Advancing the treatment of long-lasting borderline personality disorder: a feasibility and acceptability study of an expanded DBT-based skills intervention

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• dc.contributor.author Soler, Joaquim
• dc.contributor.author Casellas, Elisabet
• dc.contributor.author Pascual, Juan Carlos
• dc.contributor.author Schmidt, Carlos
• dc.contributor.author Domínguez-Clavé, Elisabet
• dc.contributor.author Cebolla, Ausiàs
• dc.contributor.author Alvear, David
• dc.contributor.author Muro, Anna
• dc.contributor.author Elices, Matilde
• dc.date.accessioned 2023-02-27T07:17:55Z
• dc.date.available 2023-02-27T07:17:55Z
• dc.date.issued 2022
• dc.description.abstract Background: 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. Methods: 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. Results: 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%. Conclusions: 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.
• dc.format.mimetype application/pdf
• dc.identifier.citation Soler J, Casellas-Pujol E, Pascual JC, Schmidt C, Domínguez-Clavé E, Cebolla A, et al. Advancing the treatment of long-lasting borderline personality disorder: a feasibility and acceptability study of an expanded DBT-based skills intervention. Borderline Personal Disord Emot Dysregul. 2022 Dec 12; 9(1): 34. DOI: 10.1186/s40479-022-00204-x
• dc.identifier.doi http://dx.doi.org/10.1186/s40479-022-00204-x
• dc.identifier.issn 2051-6673
• dc.identifier.uri http://hdl.handle.net/10230/55930
• dc.language.iso eng
• dc.publisher BMJ Publishing Group
• dc.rights Copyright © Soler J, Casellas-Pujol E, Pascual JC, Schmidt C, Domínguez-Clavé E, Cebolla A, et al. 2022. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Acceptability
• dc.subject.keyword Borderline personality disorder
• dc.subject.keyword Contextual approach
• dc.subject.keyword Dialectical behavior therapy
• dc.subject.keyword Feasibility
• dc.subject.keyword Long-lasting BPD
• dc.subject.keyword Positive psychology
• dc.subject.keyword Skills training
• dc.title Advancing the treatment of long-lasting borderline personality disorder: a feasibility and acceptability study of an expanded DBT-based skills intervention
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion