Acceptance and Commitment Therapy Group Treatment for Symptoms of Borderline Personality Disorder: A Public Sector Pilot Study

Morton, Jane F.; Snowdon, Sharon; Gopold, Michelle; Guymer, Elise

doi:10.1016/j.cbpra.2012.03.005

Cited by 70 publications

(56 citation statements)

References 39 publications

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“…For example, cognitive behavioral and acceptance-based behavioral treatments for borderline personality disorder (BPD), eating disorders, deliberate self-harm, and trichotillomania that do not focus explicitly on targeting ER have been found to improve overall ER [21–25], as well as the specific ER dimensions of: emotional awareness [21,23,24], acceptance [21,23,24,26], and clarity [21,23,24]; the ability to control behaviors in the context of emotional distress [21,24]; and access to effective strategies for modulating emotional arousal [21,24]. Moreover, these improvements in ER were found to mediate improvements in BPD symptoms [22], trichotillomania severity [26], eating disorder symptoms [21], deliberate self-harm [24], and hopelessness [22]. Both traditional cognitive-behavioral treatments and acceptance-based behavioral treatments for depression and social anxiety disorder have also been found to result in changes in the frequency of specific ER strategies (e.g., cognitive reappraisal, expressive suppression, rumination) [23,27–31].…”

Section: Impact Of Psychological Interventions On Emotion Regulationmentioning

confidence: 99%

Examining emotion regulation as an outcome, mechanism, or target of psychological treatments

Gratz

Weiss

Tull

2015

Current Opinion in Psychology

198

125

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This paper reviews the extant literature on emotion regulation (ER) in psychological interventions. First, we review current conceptualizations of ER, highlighting a model with established clinical utility (particularly with regard to the development of new interventions and modification of existing interventions). Next, we review the literature on the effects of psychological interventions on ER, from traditional cognitive-behavioral and acceptance-based behavioral interventions that do not target ER directly to treatments that directly target ER as one component of a larger or more comprehensive treatment, as well as the preliminary research examining ER as a mechanism of change in these treatments. Finally, extant data on three treatments developed specifically to address ER are reviewed, with an emphasis on the ER-specific treatment with the most empirical support to date (emotion regulation group therapy).

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Section: Impact Of Psychological Interventions On Emotion Regulationmentioning

confidence: 99%

Examining emotion regulation as an outcome, mechanism, or target of psychological treatments

Gratz

Weiss

Tull

2015

Current Opinion in Psychology

198

125

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“…ACT also encourages individuals to clarify their personal values and engage in behaviors that are consistent with these values in order to help them regulate their emotions. Randomized controlled trials have found that in adults ACT decreases: depression (Öst, 2014), psychotic symptoms (Bach and Hayes, 2002;Bach, Hayes, and Gallop, 2012;Gaudiano and Herbert, 2006;White et al, 2011), panic disorder, generalized anxiety disorder, and social anxiety (Arch et al, 2012;Avdagic, Morrissey, and Boschen, 2014), obsessive-compulsive disorder (Twohig et al, 2010), drug and nicotine dependence (Hernández-López, Luciano, Bricker, Roales-Nieto, and Montesinos, 2009;Luoma, Kohlenberg, Hayes, and Fletcher, 2012), borderline personality disorder (Gratz and Gunderson, 2006;Morton, Snowdon, Gopold, and Guymer, 2012), chronic pain (Hann and McCracken, 2014;Veehof, Oskam, Schreurs, and Bohlmeijer, 2011;Weineland, Arvidsson, Kakoulidis, and Dahl, 2012;Wetherell et al, 2011), and improves weight control (Forman et al, 2007;Juarascio, Forman, and Herbert, 2010;Lillis, Hayes, Bunting, and Masuda, 2009). Research evidence for the application of ACT with adolescents is less extensive although four randomized controlled trials have found that it can reduce depressive symptoms, unsafe sexual behaviors, chronic pain, anxiety, and stress (Hayes, Boyd, and Sewell, 2011;Livheim et al, 2014;Metzler, Biglan, Noell, Ary, and Ochs, 2000;Wicksell, Melin, Lekander, and Olsson, 2009).…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial of strong minds: A school-based mental health program combining acceptance and commitment therapy and positive psychology

Burckhardt

Manicavasagar

Batterham

et al. 2016

Journal of School Psychology

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To date, most early intervention programs have been based on emotion regulation strategies that address dysfunctional cognitive appraisals, problem-solving skills, and rumination. Another emotion regulation strategy, 'acceptance' training, has largely been overlooked. To examine the efficacy of this strategy, a school-based mental health program combining positive psychology with acceptance and commitment therapy (Strong Minds) was evaluated in a randomized controlled trial with a sample of 267 Year 10 and 11 high-school students in Sydney, Australia. Mixed models for repeated measures examined whether the program led to reductions in symptoms amongst students who commenced the program with high depression, anxiety, and stress scores, and increased wellbeing scores amongst all students. Results demonstrated that compared to controls, participants in the Strong Minds condition with elevated symptom scores (n=63) reported significant reductions in depression (p=.047), stress (p=.01), and composite depression/anxiety symptoms (p=.02) with medium to strong effect sizes (Cohen's d=0.53, 0.74, and 0.57, respectively). Increased wellbeing (p=.03) in the total sample and decreased anxiety scores (p=.048) for students with elevated symptoms were significant for Year 10 students with medium effect sizes (Cohen's d=0.43 and 0.54, respectively). This study tentatively suggests that including the emotion regulation strategy of acceptance in early intervention programs may be effective in reducing symptoms and improving wellbeing in high school students. Further research to investigate the generalizability of these findings is warranted.

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“…Acceptance and commitment therapy (ACT) (Hayes, Strosahl, & Wilson, ) is one candidate that may overcome implementation barriers in AOD settings, because it is theoretically aligned with prominent AOD counselling approaches (e.g., mindfulness based relapse prevention (MBRP), Bowen, Chawla, & Marlatt, ). Furthermore, promising findings have been demonstrated for the efficacy of ACT (Hayes et al, ) in the treatment of SUD (e.g., Gifford et al, ; Hayes et al, ; Smout et al, ) and BPD (“ Wise Choices ,” Morton, Snowdon, Gopold, & Guymer, ). The use of ACT to address co‐occurring SUD and BPD is yet to be examined.…”

Section: Introductionmentioning

confidence: 99%

Emotional dysregulation as a target in the treatment of co‐existing substance use and borderline personality disorders: A pilot study

Hall

Simpson

O’Donnell

et al. 2018

Clinical Psychologist

Self Cite

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Background Borderline personality disorder (BPD) and substance use disorders (SUD) are frequently co‐morbid and their co‐occurrence exacerbates the symptomatology and associated harms for both disorders. However, few intervention studies have examined the delivery of an integrated intervention for BPD and SUD within alcohol and other drug (AOD) treatment settings. This single arm pilot study examined the clinical utility and outcomes of a 12‐session emotion regulation intervention for clients with co‐occurring SUD and BPD symptoms delivered in an outpatient AOD treatment setting. Method Forty‐five adult treatment‐seekers (64.4% women, mean age 35.8 years (SD = 10.4)) attending an outpatient AOD service, who exhibited three or more symptoms of BPD, engaged in a 12‐session emotion regulation intervention. Clinical measures assessing alcohol and drug use, BPD symptoms, emotion dysregulation and acceptance, non‐avoidance of thoughts and emotions, and psychological flexibility were collected at baseline, session 6 and session 12. Treatment engagement, satisfaction, and rapport were also measured. Results Fifty‐one percent of participants completed the 12‐session intervention. The results demonstrated that the number of drugs using occasions in the past 28 days significantly reduced from baseline compared to session 12. Furthermore, a significant reduction was identified in BPD symptom severity, emotion dysregulation, and non‐acceptance, experiential avoidance, and psychological inflexibility from baseline to session 12. Conclusions For those individuals who completed the 12‐session emotion regulation intervention, there were significant reductions across a number of clinical outcomes. However, retention in treatment for this vulnerable client group remains a significant challenge in the AOD setting.

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Acceptance and Commitment Therapy Group Treatment for Symptoms of Borderline Personality Disorder: A Public Sector Pilot Study

Cited by 70 publications

References 39 publications

Examining emotion regulation as an outcome, mechanism, or target of psychological treatments

Examining emotion regulation as an outcome, mechanism, or target of psychological treatments

A randomized controlled trial of strong minds: A school-based mental health program combining acceptance and commitment therapy and positive psychology

Emotional dysregulation as a target in the treatment of co‐existing substance use and borderline personality disorders: A pilot study

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