Support, interventions and outcomes for families/carers of people with borderline personality disorder: A systematic review

Abstract

It is clear from existent literature that families and carers of relatives and friends with borderline personality disorder (BPD) experience high levels of burden. Whilst family interventions are considered vital to improving the outcomes of those with a range of mental health difficulties, there has been limited development of direct interventions for carers of people with BPD, despite a high level of need. This systematic review aimed to appraise and synthesize the existing research evidence for interventions for carers of people with BPD. Ten studies were included that were directly related to six interventions for families and carers of people with personality disorder. The findings of these studies, whilst limited, do provide some initial evidence that interventions for carers may lead to significant outcomes for the participants, particularly in improving carer well-being and reducing carer burden.

A pilot trial of moderated online social therapy for family and friends of young people with borderline personality disorder features

“…Carers 1 of people with BPD experience the greatest severity of burden relative to other family psychiatric populations (Bailey & Grenyer, 2013; Seigerman et al, 2020). As reported in a recent systematic review (Sutherland et al, 2019), non‐randomized pre–post studies, with small sample sizes, of carers of individuals with a personality disorder, have demonstrated a reduction in caregiver burden. However, the two recent randomized controlled trials (RCTs), each comparing active psychoeducation with a wait list control did not demonstrate a treatment effect for burden of caregiving (Bateman & Fonagy, 2019; Grenyer et al, 2019).…”

Expressed emotion in significant others of individuals with borderline personality disorder.

“…First, emotional overinvolvement may exacerbate BPD, although causality cannot be clearly inferred from these results. Interventions for CCs emphasize decreasing critical comments through increasing helpful communication such as validation (Sutherland et al, 2020). However, less work explicitly addresses ways to reduce emotional overinvolvement and change patterns of interaction between people with BPD and CCs that may involve CCs inadvertently accommodating and potentially reinforcing BPD.…”

Future Challenges in Psychotherapy Research for Personality Disorders

“…A related aspect is to increase public participation by including patients and relatives in the research. Examples include providing psychoeducation for families and carers of patients with PDs [62,63]. Co-designing research that is both rigorous and inclusive is critical [48].…”