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A schema-focused approach to group psychotherapy for outpatients with borderline personality disorder: A randomized controlled trial
Abstract
This study tests the effectiveness of adding an eight-month, thirty-session schema-focused therapy (SFT) group to treatment-as-usual (TAU) individual psychotherapy for borderline personality disorder (BPD). Patients (N=32) were randomly assigned to SFT-TAU and TAU alone. Dropout was 0% SFT, 25% TAU. Significant reductions in BPD symptoms and global severity of psychiatric symptoms, and improved global functioning with large treatment effect sizes were found in the SFT-TAU group. At the end of treatment, 94% of SFT-TAU compared to 16% of TAU no longer met BPD diagnosis criteria (p<.001). This study supports group SFT as an effective treatment for BPD that leads to recovery and improved overall functioning.
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In the citing paper
“The authors report findings resulting in very large, statistically significant effects for all reported pathology-related outcomes, that is, BPD severity, affective instability, impulsivity, interpersonal problems, dissociative/psychotic symptoms, general psychopathology, and overall mental health status.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Farrell 2009
In the citing paper
“Weekly supervision meetings took place during the course of the study and random videotapes of sessions were reviewed for fidelity by the program developers.The manual developed for the study acted as an additional fidelity check.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Farrell 2009
In the citing paper
“Again, Farrell 2009 report data indicating a very large, statistically significant difference in favour of SFT-G (SMD 1.20; N = 28, 95% CI 0.38 to 2.03; Analysis 2.15).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Farrell 2009
In the citing paper
“(Farrell 2009, p. 319) Overall, observer-rated outcomes were not assessed by blind raters.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Farrell 2009
In the citing paper
“Two of the three groups had the two program developers as therapists and the third had one developer and one clinical psychologist”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Farrell 2009
In the citing paper
“Farrell 2009 report data indicating a very large, statistically significant effect in favour of SFT-G (SMD -1.66; N = 28, 95% CI -2.54 to -0.78; Analysis 2.1).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Farrell 2009
In the citing paper
“One trial (Farrell 2009) providing mainly interviewer-assessed outcomes reported that the interviewers were not blind to treatment allocation, and the risk of bias was judged likely.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Farrell 2009
In the citing paper
“They were chosen as raters since they were removed from the hypotheses of the study, although not blind to their patients's group membership and no inter-rater reliability was possible.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Farrell 2009
In the citing paper
“Farrell 2009 report data indicating a very large, statistically significant difference between the two conditions with better outcomes for the SFT-G group (SMD -1.06, N = 28, 95% CI -1.87 to -0.25; Analysis 2.14).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Farrell 2009
In the citing paper
“High risk”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Farrell 2009
In the citing paper
“Allocation concealment (selection bias) Unclear risk No further details.”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Farrell 2009
In the citing paper
“Farrell 2009 found a very large, statistically significant difference favouring SFT-G with regard to BPD-specific impulsivity (SMD -1.92; N = 28, 95% CI -2.85 to -1.00; Analysis 2.5).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Farrell 2009
In the citing paper
“Patients were randomly assigned using a random number table”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Farrell 2009
In the citing paper
“the RCT of Farrell et al. [80] compared the effectiveness of adding 30 group sessions of ST to TAU and TAU alone in patients with BPD and found significantly greater reductions in BPD symptoms and global severity of psychiatric symptoms in the GST.”
In the citing paper
“Both treatments are well documented [17, 24, 75] and have been implemented in scientific research before in treatment studies for GCBT (e.g. [76–79]) and individual and group ST (e.g. [19, 43, 80, 81]).”
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 Farrell et al., 2009
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3 of the 38 references couldn’t be matched to a known paper.
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Metadata
- Authors
- Farrell, J. M., Shaw, I. A., & Webber, M. A.
- Affiliations
- Indiana University Hospital (US)
- Corresponding author
- Farrell, Joan M.
- Venue
- Journal of Behavior Therapy and Experimental Psychiatry
- Publisher
- Elsevier BV
- Published
- 2009-06
- Volume
- 40
- Issue
- 2
- Pages
- 317-328
- ISSN
- 0005-7916 (ISSN-L)
- OpenAlex
- W2156247218
- Cited by
- 428
- References
- 38
- Citations by year
- 2026: 12 · 2025: 17 · 2024: 19 · 2023: 20 · 2022: 30 · 2021: 27 · 2020: 42 · 2019: 22 · 2018: 25 · 2017: 28 · 2016: 29 · 2015: 30 · 2014: 29 · 2013: 26 · 2012: 36
- FWCI
- 25.17
- Type
- journal article
- Language
- en
- Update notices
- erratum (2018-09-01)
- Open access
- closed
- Locations
- Journal of Behavior Therapy and Experimental Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- schema therapy, borderline personality disorder, group therapy, outpatient care, individual psychotherapy, treatment discontinuation, psychiatric symptom severity, global functioning
- MeSH terms
- Adult, Borderline Personality Disorder, Female, Humans, Interview, Psychological, Middle Aged, Outpatients, Psychiatric Status Rating Scales, Psychotherapy, Group, Socioeconomic Factors, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult
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