Integration of e‐Health Tools Into Face‐to‐Face Psychotherapy for Borderline Personality Disorder: A Chance to Close the Gap Between Demand and Supply?

Abstract

Borderline personality disorder (BPD) is a severe, highly prevalent mental disorder. Effective psychological treatments for BPD are available. However, most patients do not receive evidence-based treatments partly because of high treatment delivery costs and lack of specialized therapists. By integrating specialized e-health tools into BPD-specific treatments, treatment intensity can be increased, frequency of face-to-face sessions and burden for psychotherapists can be reduced, and implementation of new skills and experiences in the everyday life of these patients can be promoted. This bears great potential to increase the availability of evidenced-based psychotherapy for BPD patients and close the gap between demand and supply. In this article we present such an innovative e-health tool, priovi, which has been developed for schema therapy. The concept and application of priovi are described and illustrated with a case example.

Therapeutic Relationship in eHealth—A Pilot Study of Similarities and Differences between the Online Program Priovi and Therapists Treating Borderline Personality Disorder

“…This study emerged from a pilot study concerning the feasibility and safety of priovi in conjunction with face-to-face ST at the Department of Psychiatry and Psychotherapy, University of Lübeck, Germany, in cooperation with GAIA AG (Hamburg, Germany), the company that developed priovi [ 15 , 20 ]. Approval was granted by the Ethics Committee of the University of Lübeck (AZ 14-038).…”

“…Priovi also provides some other features like a glossary explaining the most important terms around BPD and ST or a “mode toolbox” where exercises can be stored and revisited. A more detailed description of priovi can be found elsewhere [ 15 , 20 ].…”

“…As it is based on ST, priovi tries to establish a good therapeutic alliance with the patient by using a validating, soothing, and friendly tone. [ 20 ].…”

“…One of the reasons why there are so few studies on internet interventions of BPD are concerns that BPD patients need interpersonal contact and a stable therapeutic alliance in treatment and that these needs cannot be met by an e-health tool [ 20 ].…”

Why go to the emergency department? Perspectives from persons with borderline personality disorder

“…Strategies including the use of eHealth, warrant further exploration, though current evidence of their effectiveness is promising (Kudlow 2013). For example, in a pilot study of a BPD eHealth tool that provides tailored communication and education through messages and activities, Fassbinder et al (2015) reported a significant decrease in BPD-related symptoms after 6 months of usethough more rigorous testing is required to determine true effectiveness. Furthermore, urgent care facilities for psychiatric needs provide a safe alternative to ED care for patients experiencing acute and persistent psychiatric symptoms.…”