For detailed information about these treatments, the reader is referred to the Methods/design section. ST is based on an integrative cognitive therapy, combining cognitive behavior and experiential therapy techniques with concepts derived from developmental theories, including attachment theory, and psychodynamic concepts. DBT is a comprehensive cognitive behavioral treatment for BPD, rooted in behaviorism, Zen and dialectical philosophy. During recent years, a number of promising treatments have been developed and evaluated, including Dialectical Behavior Therapy (DBT) and Schema Therapy (ST). Interventions: dialectical behavior therapy and schema therapyīPD has traditionally been viewed as one of the most difficult mental disorders to treat. BPD is also associated with high non-healthcare costs, including costs related to productivity losses, informal care, and out-of-pocket costs. BPD patients make extensive use of treatment services resulting in markedly higher healthcare costs of people with BPD compared to people with other mental disorders, such as other personality disorders and depressive disorder. Besides the detrimental effects of BPD on the individual patient, BPD also poses a high financial burden to society. Moreover, BPD is related to a high risk of suicide (3–6%, or even up to 10% ) and suicide attempts or threats (up to 84% ), and an increased mortality rate. In addition, BPD is characterized by low quality of life lower compared to other common mental disorders such as depressive disorder, and comparable to that of patients with severe physical conditions, such as Parkinson’s disease and stroke. BPD is associated with severe functional impairment, high rates of comorbid mental disorders, and physical health problems. The prevalence in the general population is estimated to be between 1 and 3%, and 10 to 25% among psychiatric outpatient and inpatient individuals. Netherlands Trial Register, NL7699, registered - retrospectively registered.īorderline personality disorder (BPD) is a complex and severe mental disorder, characterized by a pervasive pattern of instability in emotion regulation, self-image, interpersonal relationships, and impulse control. The current study contributes to the optimization of treatments for BPD patients by extending our knowledge on “Which treatment – DBT or ST – works the best for which BPD patient, and why?”, which is likely to yield important benefits for both BPD patients (e.g., prevention of overtreatment and potential harm of treatments) and society (e.g., increased economic productivity of patients and efficient use of treatments). Secondary outcome measures include functioning, additional self-reported symptoms, and well-being. The primary outcome measure is change in BPD manifestations. In addition, BPD-treatment-specific (ST: beliefs and schema modes DBT: emotion regulation and skills use), BPD-treatment-generic (therapeutic environment characterized by genuineness, safety, and equality), and non-specific (attachment and therapeutic alliance) mechanisms of change are assessed. Candidate predictors of (differential) treatment response have been selected based on the literature, a patient representative of the Borderline Foundation of the Netherlands, and semi-structured interviews among 18 expert clinicians. Data are collected at baseline until three-year follow-up. Patients receive a combined program of individual and group sessions for a maximum duration of 25 months. We aim to recruit 200 participants, to be randomized to DBT or ST. The BOOTS trial is a multicenter randomized clinical trial conducted in a routine clinical setting in several outpatient clinics in the Netherlands. Moreover, the clinical effectiveness and cost-effectiveness of DBT and ST will be evaluated. The aim of the present study is to improve treatment response of DBT and ST for BPD patients by a) identifying patient characteristics that predict (differential) treatment response (i.e., treatment selection) and b) understanding how both treatments lead to change (i.e., mechanisms of change). Understanding which treatment works best for whom and why remain central issues in psychotherapy research. Individual differences in treatment response to both ST and DBT have been observed across studies, but the factors driving these differences are largely unknown. Specialized evidence-based treatments have been developed and evaluated for borderline personality disorder (BPD), including Dialectical Behavior Therapy (DBT) and Schema Therapy (ST).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |