Abstract
Schema therapy (ST) has been found to be effective in the treatment of borderline personality disorder (BPD). However very little is known about how the therapy is experienced by individuals with BPD including which specific elements of ST are helpful or unhelpful from their perspectives. The aim of this study is to explore BPD patients’ experiences of receiving ST, in intensive group or combined group-individual format. Qualitative data were collected through semi-structured interviews with 36 individuals with a primary diagnosis of BPD (78% females) who received ST for at least 12 months. Participants were recruited as part of an international, multicenter randomized controlled trial (RCT). Interview data (11 Australian, 12 Dutch, 13 German) were analyzed following the procedures of qualitative content analysis. Patients’ perceptions of the benefits gained in ST included improved self-understanding, and better awareness and management of their own emotional processes. While some aspects of ST, such as experiential techniques were perceived as emotionally confronting, patient narratives informed that this was necessary. Some recommendations for improved implementation of ST include the necessary adjunct of individual sessions to group ST and early discussion of therapy termination. Implications of the findings are also discussed, in particular the avenues for assessing the suitability of patients for group ST; management of group conflict and the optimal format for delivering treatment in the intensive group versus combined group-individual formats.
Highlights
Borderline personality disorder (BPD) is a pervasive, debilitating psychological condition found in 28.5% of clinical populations and between 0.8% and 1.6% among community samples [1, 2]
There is an absence of qualitative information on how Schema Therapy (ST) and GST is experienced by BPD patients. Such information is important as qualitative methods enable an understanding of how the therapy is received by patients which is a perspective not often available by measuring symptoms or quality of life ratings. This study explored such experiences, in particular: 1. Aspects of individual and group ST that were helpful in facilitating recovery from BPD
The purpose of this study was to understand the experience of ST for individuals with BPD
Summary
Borderline personality disorder (BPD) is a pervasive, debilitating psychological condition found in 28.5% of clinical populations and between 0.8% and 1.6% among community samples [1, 2]. ST was developed as a treatment for personality disorders and other chronic symptom disorders It is an integrative form of psychotherapy that incorporates concepts and approaches from Cognitive Behaviour Therapy (CBT), attachment theory, gestalt therapy and psychodynamic perspectives. The first is Early Maladaptive Schemas (EMS), defined as pervasive and self-defeating, dysfunctional patterns of thoughts, cognitions, behaviours and affects that typically develop during childhood but become elaborated on throughout the person’s life [8]. These EMS develop when there is a mismatch between a child’s basic needs and their environment. Patients with BPD have been found with elevated scores on most schemas compared to other population groups, in need for connection domain [10]
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