Tuesday, April 22, 2008

STEPPS for Borderline Personality Disorder

The treatment of Borderline Personality Disorder is challenging. The use of medication has increased but while several drugs have proved useful their benefit has been modest. A range of psychotherapies has been developed and several have shown good results including dialectical behaviour therapy, mentalization-based therapy, cognitive-behavioural therapy (CBT), schema-focused therapy and transference-focused therapy. Systems Training for Emotional Predictability and Problem Solving (STEPPS) was developed in 1995 and combines CBT and skills training with a systems component for individuals with whom a patient regularly interacts. A U.S. study of 124 patients compared those taking part in the STEPPS programme with those receiving treatment as usual. Those taking part in STEPPS showed a greater overall improvement and became less impulsive, had less negative affectivity and mood, and functioned better. They also had less visits to emergency departments during treatment and follow-up. However, there were no differences between the groups in terms of sucide attempts or self-injury.

Blum, Nancee ... [et al] - Systems Training for Emotional Predictability and Problem Solving (STEPPS) for outpatients with borderline personality disorder: a randomized controlled trial and 1-year follow-up American Journal of Psychiatry April 2008, 165(4), 468-478

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