Solution-focused therapy groups for borderline personality disorder: a preliminary study

Abstract

Objective: To investigate the effectiveness of an adjunctive, community-based, Solution-focused therapy (SFT) group for Borderline Personality Disorder (BPD) in terms of change in clinical symptoms and the subjective experiences of participants. Methods: The study employed a mixed-methods, naturalistic, service-evaluation design in which 9 outpatients with Borderline Personality Disorder (BPD) attended 16-session SFT groups, and were assessed on clinically-relevant outcomes at baseline, 8 sessions and following group completion. Participants provided qualitative information about pre-intervention hopes and were interviewed post-group about their experience of the groups. Repeated-measures ANOVA was used to assess change in clinical symptoms during treatment, and a priori contrasts were conducted to explore significant results. Qualitative data was analysed inductively using semantic-level, thematic analysis as described by Braun and Clarke (2006). Results: Improvements were indicated across all clinical outcomes with the most robust evidence of significant effects for: phobic anxiety; paranoid ideation; psychoticism; interpersonal functioning; and symptom severity. Qualitative analyses indicated that the intervention successfully addressed the hopes of the participants and that they valued: normalisation; acceptance and safety; the opportunity to share and work together; mutual support; an informal and non-directive atmosphere; and assistance with the pursuit of personally meaningful goals. They reported noticing change, progress towards their goals, and a subjective sense that they were coping better and feeling better. Conclusions: The study provides some preliminary evidence for the effectiveness of the intervention and it may represent a more easily-accessible, resource-efficient, less intensive alternative to specialised services. More general implications in relation to approaches to treatment for BPD are discussed.