Schema therapy for borderline personality disorder: a qualitative study of patients’ perceptions
Tan YM, Lee CW, Averbeck LE, et al. Schema therapy for borderline personality disorder: a qualitative study of patients’ perceptions. PLoS One. 2018;13(11):e0206039. doi:10.1371/journal.pone.0206039
What the study asked
Schema therapy (ST) is an effective treatment for borderline personality disorder (BPD), but little was known about how people with BPD experience it, and which parts they find helpful or hard. This study asked them.
How it was done
The researchers interviewed 36 people with a main diagnosis of BPD (78% women) who had received ST for at least 12 months, in an intensive group format or a combined group and individual format. Eleven were from Australia, 12 from the Netherlands and 13 from Germany. They took part in an international, multicenter randomized controlled trial. The interviews were semi-structured, and the researchers analyzed them with qualitative content analysis.
What people said
Most described gains from ST:
- Better understanding of themselves: 31 of 36 (86%).
- Being able to act differently and cope in healthier ways: 26 (72%).
- Better awareness and management of their emotions: 18 (50%).
- More confidence and assertiveness: 17 (47%).
- Less harshness toward themselves: 15 (42%).
Fourteen (39%) also commented on difficulties. Some parts, such as experiential techniques, felt emotionally confronting, but patients said this was necessary.
Recommendations
The authors suggest adding individual sessions to group ST and discussing the end of therapy early. They also discuss how to judge whether a person is suited to group ST, how to handle conflict in the group, and which format works best: intensive group or combined group and individual.
If this brings up something difficult, you don't have to deal with it alone. Talk to your therapist, or open the Crisis tab in the CopingCard app.