Family Connections versus optimised treatment-as-usual for family members of individuals with borderline personality disorder: non-randomised controlled study
Open accessAbstract
Borderline personality disorder (BPD) is challenging for family members who are often required to fulfil multiple roles such as those of advocate, caregiver, coach and guardian. To date, two uncontrolled studies by the treatment developers suggest that Family Connections (FC) is an effective programme to support, educate and teach skills to family members of individuals with BPD. However, such studies have been limited by lack of comparison to other treatment approaches. This study aimed to compare the effectiveness of FC with an optimised treatment-as-usual (OTAU) programme for family members of individuals with BPD. A secondary aim was to introduce a long term follow-up to investigate if positive gains from the intervention would be maintained following programme completion. This study was a non-randomised controlled study, with assessment of outcomes at baseline (pre-intervention) and end of programme (post-intervention) for both FC and OTAU groups, and at follow-up (3 months post-intervention; 12 or 19 months post-intervention) for the FC group. Eighty family members participated in the FC ( n = 51) and the OTAU ( n = 29) programmes. Outcome measures included burden, grief, depression and mastery. Linear mixed-effects models were used to assess baseline differences in the outcome measures by gender, age group and type of relationship to the individual with BPD. Linear mixed-effects models were also used to estimate the treatment effect (FC versus OTAU) utilising all available data from baseline and end of programme. The FC group showed changes indicating significant improvement with respect to all four outcome measures ( p < 0.001). The OTAU group showed changes in the same direction as the intervention group but none of the changes were statistically significant. The intervention effect was statistically significant for total burden (including both subscales; p = .02 for subjective burden and p = .048 for objective burden) and grief ( p = 0.013). Improvements were maintained at follow-up for FC participants. The findings of the current study indicate that FC results in statistically significant improvements on key measures while OTAU does not yield comparable changes. Lack of significant change on all measures for OTAU suggests that a three session psycho-education programme is of limited benefit. Further research is warranted on programme components and long-term supports for family members.
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FC was superior to optimized treatment as usual in reducing both subjective and objective burden and grief.
“Los resultados mostraron que la FC® fue superior al tratamiento habitual optimizado en reducir tanto la sobrecarga subjetiva y objetiva como el duelo.”
From Efectividad y aceptabilidad del entrenamiento en habilidades de la terapia dialéctica comportamental para familiares de personas con trastorno de personalidad límite (2019) · cites this paper as Flynn et al., 2017
Flynn et al. (2017) conducted a non-randomized study in Ireland comparing FC (n=51) with optimized treatment as usual (n=29).
“Por otro lado, recientemente Flynn et al., (2017) llevaron a cabo un estudio no aleatorizado en Irlanda en el que compararon el programa FC® (n = 51) con un tratamiento habitual optimizado (n = 29).”
From Efectividad y aceptabilidad del entrenamiento en habilidades de la terapia dialéctica comportamental para familiares de personas con trastorno de personalidad límite (2019) · cites this paper as Flynn et al., 2017
Improvements were maintained at follow-ups (3, 12, or 19 months) in the FC group.
“Las mejorías se mantuvieron en los seguimientos (3, 12 o 19 meses) en el grupo FC®.”
From Efectividad y aceptabilidad del entrenamiento en habilidades de la terapia dialéctica comportamental para familiares de personas con trastorno de personalidad límite (2019) · cites this paper as Flynn et al., 2017
Porcentajes de abandono similares se obtuvieron en el estudio pre-post que evaluó el programa Friends and Family y los estudios sobre FC.
“Porcentajes de abandono similares se obtuvieron en el estudio pre-post que evaluó el programa Friends and Family (Wilks et al., 2017) y los estudios sobre FC (p.ej.Flynn et al., 2017).”
From Efectividad y aceptabilidad del entrenamiento en habilidades de la terapia dialéctica comportamental para familiares de personas con trastorno de personalidad límite (2019) · cites this paper as Flynn et al., 2017
El resultado de un tamaño del efecto grande en agotamiento emocional es alentador, va en la línea de previas investigaciones que evaluaron el programa FC y sugiere que incluir componentes específicos para las relaciones familiares podría disminuir la sobrecarga emocional del cuidador.
“Este resultado es alentador, ya que va en la línea de previas investigaciones que evaluaron el programa FC (Flynn et al., 2017;Hoffman et al., 2005;Hoffman, et al., 2007;Rajalin et al., 2009) y sugiere que incluir componentes específicos para las relaciones familiares podría disminuir la sobrecarga emocional del cuidador.”
From Efectividad y aceptabilidad del entrenamiento en habilidades de la terapia dialéctica comportamental para familiares de personas con trastorno de personalidad límite (2019) · cites this paper as Flynn et al., 2017
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- Authors
- Flynn, D., Kells, M., Joyce, M., Corcoran, P., Herley, S., Suarez, C., Cotter, P., Hurley, J., Weihrauch, M., & Groeger, J.
- Affiliations
- Health Service Executive (IE)
- University College Cork (IE)
- Corresponding author
- Joyce, Mary
- Venue
- Borderline Personality Disorder and Emotion Dysregulation
- Published
- 2017-08-30
- Volume
- 4
- Issue
- 1
- Pages
- 18-18
- ISSN
- 2051-6673 (ISSN-L)
- PMC
- PMC5575921
- OpenAlex
- W2753899139
- Cited by
- 66
- References
- 19
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 18 · 2023: 7 · 2022: 9 · 2021: 7 · 2020: 8 · 2019: 6 · 2018: 2
- FWCI
- 5.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Borderline Personality Disorder and Emotion Dysregulation (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Nottingham Trent University's Institutional Repository (Nottingham Trent Repository) (acceptedVersion)
- Cork Open Research Archive (University College Cork, Ireland) (acceptedVersion, cc-by)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion, cc-by)
- Cork Open Research Archive (University College Cork, Ireland) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Lenus, The Irish Health Repository (Dr Steevens Hospital Library) (submittedVersion)
- Funders
- National Office for Suicide Prevention
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Keywords
- borderline personality disorder, family members, caregiver burden, grief, depression, mastery, psychoeducation, family intervention, long-term follow-up, treatment effects
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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