Abstract
BackgroundStructured psychotherapy is recommended as the preferred treatment of personality disorders. A substantial group of patients, however, has no access to these therapies or does not benefit. For those patients who have no (longer) access to psychotherapy a Collaborative Care Program (CCP) is developed. Collaborative Care originated in somatic health care to increase shared decision making and to enhance self management skills of chronic patients. Nurses have a prominent position in CCP's as they are responsible for optimal continuity and coordination of care. The aim of the CCP is to improve quality of life and self management skills, and reduce destructive behaviour and other manifestations of the personality disorder.Methods/designQuantitative and qualitative data are combined in a comparative multiple case study. This makes it possible to test the feasibility of the CCP, and also provides insight into the preliminary outcomes of CCP. Two treatment conditions will be compared, one in which the CCP is provided, the other in which Care as Usual is offered. In both conditions 16 patients will be included. The perspectives of patients, their informal carers and nurses are integrated in this study. Data (questionnaires, documents, and interviews) will be collected among these three groups of participants. The process of treatment and care within both research conditions is described with qualitative research methods. Additional quantitative data provide insight in the preliminary results of the CCP compared to CAU. With a stepped analysis plan the 'black box' of the application of the program will be revealed in order to understand which characteristics and influencing factors are indicative for positive or negative outcomes.DiscussionThe present study is, as to the best of our knowledge, the first to examine Collaborative Care for patients with severe personality disorders receiving outpatient mental health care. With the chosen design we want to examine how and which elements of the CC Program could contribute to a better quality of life for the patients.Trial registrationNetherlands Trial Register (NTR): NTR2763
Highlights
Structured psychotherapy is recommended as the preferred treatment of personality disorders
With the chosen design we want to examine how and which elements of the Collaborative Care (CC) Program could contribute to a better quality of life for the patients
A substantial group of patients with borderline or not otherwise specified (NOS) personality disorders does, for different reasons, not participate in evidence based psychotherapeutic programs aimed at structural changes in personality and recovery
Summary
A substantial group of patients with borderline or NOS personality disorders does, for different reasons, not participate in evidence based psychotherapeutic programs aimed at structural changes in personality and recovery. Our Collaborative Care Program may function as a valuable alternative for the relatively unstructured treatment which dominates the care as usual within existent community mental health care teams [16,17]. Within these CMHC teams nurses are the main care providers, they are not always equipped to meet this responsibility. The present study is, as to the best of our knowledge, the first to examine Collaborative Care for patients with severe personality disorders receiving outpatient mental health care. Additional file 1: A Collaborative Care Program for patients with severe borderline or NOS personality disorders. This additional file elucidates the content of the Collaborative Care Program in more detail
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