STEPPS: A cognitive-behavioral systems-based group treatment for outpatients with borderline personality disorder—a preliminary report

Blum, Nancee; Pfohl, Bruce; John, Don St.; Monahan, Patrick O.; Black, Donald W.

doi:10.1053/comp.2002.33497

Cited by 163 publications

(129 citation statements)

References 24 publications

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“…The other main limitation is the response rate. Nevertheless, 43% is better than response rates for postal surveys among people with both personality disorder 10 and depression. 11 It may have been possible to reduce the amount of missing data by integrating the completion of questionnaires into group sessions.…”

Section: Discussionmentioning

confidence: 93%

Open access community support groups for people with personality disorder: attendance and impact on use of other services

Miller

Crawford

2010

Psychiatrist

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Aims and method To describe a new open access community service for people with personality disorder and to explore interim service utilisation and outcomes. Routine data were analysed together with those from a cross-sectional survey.Results During the first 16 months of the service, 171 people attended, of whom 142 (83.0%) returned on at least one other occasion. The median number of attendances was seven (IQR = 3.0-22.0). Over 90% of responders to the survey met criteria for 'probable personality disorder' and levels of social dysfunction were high. Presentations to emergency services, contacts with other services and in-patient admissions were reduced. Social functioning improved.Clinical implications This service attracted a large number of people with significant health and social problems. Use of the service was associated with improved social functioning and reduced use of other services.

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Section: Discussionmentioning

confidence: 93%

Open access community support groups for people with personality disorder: attendance and impact on use of other services

Miller

Crawford

2010

Psychiatrist

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“…[15][16][17] One relatively brief skills-training approach to improving problem-solving that has been evaluated specifically with people with borderline PD is the Systems Training for Emotional Predictability and Problem Solving (STEPPS) programme. 18 STEPPS is a 20-week group treatment programme for individuals with PD and others within that person's system, such as family members, partners, friends and health-care professionals. STEPPS focuses on psychoeducation, emotion management training and behaviour management training.…”

Section: Personality Disordermentioning

confidence: 99%

Psychoeducation with problem-solving (PEPS) therapy for adults with personality disorder: a pragmatic randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of a manualised intervention to improve social functioning

McMurran

Crawford

Reilly

et al. 2016

Health Technol Assess

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If effective, less intensive treatments for people with personality disorder have the potential to serve more people.To compare the clinical effectiveness and cost-effectiveness of psychoeducation with problem-solving (PEPS) therapy plus usual treatment against usual treatment alone in improving social problem-solving with adults with personality disorder.Multisite two-arm, parallel-group, pragmatic randomised controlled superiority trial.Community mental health services in three NHS trusts in England and Wales.Community-dwelling adults with any personality disorder recruited from community mental health services.Up to four individual sessions of psychoeducation, a collaborative dialogue about personality disorder, followed by 12 group sessions of problem-solving therapy to help participants learn a process for solving interpersonal problems.The primary outcome was measured by the Social Functioning Questionnaire (SFQ). Secondary outcomes were service use (general practitioner records), mood (measured via the Hospital Anxiety and Depression Scale) and client-specified three main problems rated by severity. We studied the mechanism of change using the Social Problem-Solving Inventory. Costs were identified using the Client Service Receipt Inventory and quality of life was identified by the European Quality of Life-5 Dimensions questionnaire. Research assistants blinded to treatment allocation collected follow-up information.There were 739 people referred for the trial and 444 were eligible. More adverse events in the PEPS arm led to a halt to recruitment after 306 people were randomised (90% of planned sample size); 154 participants received PEPS and 152 received usual treatment. The mean age was 38 years and 67% were women. Follow-up at 72 weeks after randomisation was completed for 62% of participants in the usual-treatment arm and 73% in the PEPS arm. Intention-to-treat analyses compared individuals as randomised, regardless of treatment received or availability of 72-week follow-up SFQ data. Median attendance at psychoeducation sessions was approximately 90% and for problem-solving sessions was approximately 50%. PEPS therapy plus usual treatment was no more effective than usual treatment alone for the primary outcome [adjusted difference in means for SFQ -0.73 points, 95% confidence interval (CI) -1.83 to 0.38 points; p = 0.19], any of the secondary outcomes or social problem-solving. Over the follow-up, PEPS costs were, on average, £182 less than for usual treatment. It also resulted in 0.0148 more quality-adjusted life-years. Neither difference was statistically significant. At the National Institute for Health and Care Excellence thresholds, the intervention had a 64% likelihood of being the more cost-effective option. More adverse events, mainly incidents of self-harm, occurred in the PEPS arm, but the difference was not significant (adjusted incidence rate ratio 1.24, 95% CI 0.93 to 1.64).There was possible bias in adverse event recording because of dependence on self-disclosure or reporting by the clini...

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“…Solving (STEPPS) program for adults with borderline PD (195) that combines group-based skills training with family psychoeducation. In both studies, the effectiveness of ERT was compared with TAU.…”

Section: Two Rcts Have Investigated the Effectiveness Of Emotion Regumentioning

confidence: 99%

Personality Disorder in Childhood and Adolescence comes of Age: a Review of the Current Evidence and Prospects for Future Research

Kongerslev

Chanen

Simonsen

2014

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

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In this article, the authors provide a narrative review of the mounting evidence base on personality disorder in childhood and adolescence. Topics covered include diagnostic validity, prevalence, developmental issues, comorbidity, risk and protective factors, and treatment. Novel indicated prevention and early intervention programs for borderline personality disorder in adolescence are given special priority. To conclude, directions for future research are provided.

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STEPPS: A cognitive-behavioral systems-based group treatment for outpatients with borderline personality disorder—a preliminary report

Cited by 163 publications

References 24 publications

Open access community support groups for people with personality disorder: attendance and impact on use of other services

Open access community support groups for people with personality disorder: attendance and impact on use of other services

Psychoeducation with problem-solving (PEPS) therapy for adults with personality disorder: a pragmatic randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of a manualised intervention to improve social functioning

Personality Disorder in Childhood and Adolescence comes of Age: a Review of the Current Evidence and Prospects for Future Research

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