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Implementation of outpatient schema therapy for borderline personality disorder with versus without crisis support by the therapist outside office hours: A randomized trial
Abstract
Objective This study aimed to evaluate the success of implementing outpatient schema focused therapy (ST) for borderline patients in regular mental healthcare and to determine the added value of therapist telephone availability outside office hours in case of crisis (TTA).Methods To enhance the implementation, the following adaptations regarding the original ST protocol were applied: a reduction in the frequency and duration of the therapy; training therapists of eight regular healthcare centers in ST with a structured and piloted program supported by a set of films (DVDs) with examples of ST techniques; training and supervision given by Dutch experts. Telephone availability outside office hours was randomly allocated to 50% of the therapists of each treatment center. Patient's outcome measures were assessed with a semi-structured interview and self-report measures on BPD, quality of life, general psychopathology and an ST questionnaire, before, during and after treatment.Results Data on 62 DSM-IV defined BPD patients were available. Intention-to-treat analyses showed that after 1.5 years of ST 42% of the patients had recovered from BPD. No added value of therapist telephone availability (TTA) was found on the BPDSI score nor on any other measure after 1.5 years of ST.Conclusions ST for BPD can be successfully implemented in regular mental healthcare. Treatment results and dropout were comparable to a previous clinical trail. No additional effect of extra crisis support with TTA outside office hours ST was found.
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“Most published RCTs investigating ST treatments thus far comprise 50 or more sessions covering time spans of more than one year [19, 81, 87].”
In the citing paper
“Several studies have shown that treatment based on that model is very effective for patients with BPD (Giesen-Bloo et al., 2006; Farrell et al., 2009; Nadort et al., 2009; Dickhaut and Arntz, 2013), but also for other PDs (Bamelis et al., 2013).”
From Emotion regulation in schema therapy and dialectical behavior therapy. (2016) · cites this paper as Nadort et al., 2009
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Metadata
- Authors
- Nadort, M., Arntz, A., Smit, J. H., Giesen-Bloo, J., Eikelenboom, M., Spinhoven, P., van Asselt, T., Wensing, M., & van Dyck, R.
- Affiliations
- Amsterdam Public Health (NL)
- Maastricht University (NL)
- Leiden University (NL)
- Radboud University Medical Center (NL)
- Corresponding author
- Nadort, Marjon
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2009-11
- Volume
- 47
- Issue
- 11
- Pages
- 961-973
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2019444600
- Cited by
- 259
- References
- 54
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 15 · 2023: 11 · 2022: 16 · 2021: 22 · 2020: 21 · 2019: 9 · 2018: 15 · 2017: 15 · 2016: 19 · 2015: 23 · 2014: 21 · 2013: 17 · 2012: 28
- FWCI
- 17.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- schema therapy, borderline personality disorder, outpatient care, crisis support, therapist training, treatment implementation, treatment discontinuation, quality of life, psychopathology, long-term treatment outcomes
- MeSH terms
- Adult, Behavior Therapy, Borderline Personality Disorder, Female, Humans, Male, Outpatients, Treatment Outcome, Remote Consultation
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