Iconic therapy for the reduction of borderline personality disorder symptoms among suicidal youth: A randomized controlled trial study

Abstract

Background: Iconic therapy (IT) is a new therapy that uses images to teach skills with the aim of improving the symptoms of borderline personality disorder. Preliminary results are promising and the indication is that Iconic Therapy may be effective. The purpose of this randomized clinical trial was to test the effectiveness of IT compared to a psychological supportive intervention (SI).Methods: The study was carried out at the University Regional Hospital of Malaga. Young patients (N=40; 15–30 years) with suicidal or parasuicidal behavior and borderline personality traits were randomized into IT (N = 20) or SI (N = 20). The main outcome variable was a change in the symptoms of borderline personality disorder (BSL-23) at the end of treatment. The secondary outcome variables were suicidal ideation and behaviour, self-harm, the need for medication, the number of visits to mental health professionals, maladaptive behaviour, satisfaction with therapy and perceived improvement, both at the end of the intensive treatment and at the 12-month follow-up.Results: There were no significant differences between the two therapies regarding reduction of the BSL-23 score. The two therapies showed statistically significant results both at the end of intensive treatment (IT: d = 0.50; SI: d = 0.45) and at the 12-month follow-up (IT: d = 1.09; SI: d = 0.80). In the secondary outcome measures, IT showed statistically significant superiority with respect to SI in satisfaction with therapy at the end of treatment (p = 0.002).Conclusions: Although the results suggest certain superiority of Iconic therapy, it is remarkable the necessity of future studies with larger samples and comparisons with established treatments for borderline personality disorder. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03011190.