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Cohen S, Salamin V, Perroud N, Dieben K, Ducasse D, Durpoix A, Guenot F, Tissot H, Kramer U, Speranza M. Group intervention for family members of people with borderline personality disorder based on Dialectical Behavior Therapy: Implementation of the Family Connections® program in France and Switzerland. Borderline Personal Disord Emot Dysregul 2024; 11:16. [PMID: 39039536 PMCID: PMC11265349 DOI: 10.1186/s40479-024-00254-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/23/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Families and significant others of people with borderline personality disorder (BPD) show increased levels of psychological distress. Family Connections®, a 12-week group intervention based on the principles of Dialectical Behavior Therapy, was designed to provide families with both information about the disorder and emotion regulation skills. It has been progressively implemented in French-speaking European countries. METHODS We conducted an observational, multicenter study in France and Switzerland. In total, 149 participants of the Family Connections program were included among five centers. Burden, depression, coping, and emotion regulation were assessed before and after the intervention. RESULTS One-way repeated measures MANOVA showed that the burden, depressive symptoms, emotion regulation and coping all changed significantly after the intervention (p < 0.001, partial η2 = 0.297). T-tests showed that the burden significantly decreased after the intervention (p < 0.0001, d = -0.48), as did depressive symptoms (p < 0.0001, d = -0.36) and difficulties in emotion regulation (p < 0.0001, d =-0.32) whereas coping improved (p < 0.0001, d = 0.53). Two-way mixed ANOVA showed that burden reduction was stronger among female than male participants (p = 0.048, η2 = 0.027). Before the intervention, the burden was higher for female than male participants (p < 0.001). An initial linear regression showed the burden reduction to be associated with a decrease in the resignation of the participants (β = 0.19, p = 0.047). A second linear regression showed the burden reduction to be associated with the intensity of the relatives' symptoms at baseline (β = 0.22, p = 0.008) and improvement of emotional clarity of the participants (β = 0.25, p = 0.006). CONCLUSION This Dialectical Behavior Therapy-Based psychoeducational intervention is an appropriate way to support French-speaking European families of people with BPD.
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Affiliation(s)
- Satchel Cohen
- Child and Adolescent Psychiatry Care Unit, Versailles Hospital, Le Chesnay, France.
- Paris-Saclay University, UVSQ, Inserm, Centre for Research in Epidemiology and Population Health UMR 1018, Team "Developmental Psychiatry and Trajectories", 78000, Versailles, France.
| | | | - Nader Perroud
- Department of Psychiatric Specialties for Emotion Regulation Disorders, Geneva University Hospitals, 1201, Geneva, Switzerland
| | - Karen Dieben
- Department of Psychiatric Specialties for Emotion Regulation Disorders, Geneva University Hospitals, 1201, Geneva, Switzerland
| | - Déborah Ducasse
- CHU de Montpellier, Service Urgences Et Post-Urgences Psychiatriques (Lapeyronie), Centre de Thérapies Troubles de L'humeur Et Émotionnels/Borderline (La Colombière), IGF, Univ. Montpellier, CNRS, Inserm, Montpellier, France
| | - Amaury Durpoix
- Strasbourg University Hospital, 67000, Strasbourg, France
| | | | - Hervé Tissot
- Center for Family Studies, University Institute of Psychotherapy, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Ueli Kramer
- Lausanne University Hospital Institute of Psychotherapy/General Psychiatry, 1003, Lausanne, Switzerland
| | - Mario Speranza
- Child and Adolescent Psychiatry Care Unit, Versailles Hospital, Le Chesnay, France.
- Paris-Saclay University, UVSQ, Inserm, Centre for Research in Epidemiology and Population Health UMR 1018, Team "Developmental Psychiatry and Trajectories", 78000, Versailles, France.
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Psychoeducational groups for close relatives of patients with borderline personality disorder. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01395-8. [PMID: 35294615 DOI: 10.1007/s00406-022-01395-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 03/01/2022] [Indexed: 11/03/2022]
Abstract
Psychoeducational groups for family members of patients with schizophrenia have proven to be effective. Borderline personality disorder (BPD) implies serious impairment in interpersonal relationships. Close relatives of individuals with BPD also show high levels of burden and need support. Psychoeducational groups could help to cope with the interactional problems in a relationship with a person with BPD. A manualised psychoeducational programme of 10 group sessions for close relatives of patients with BPD was tested. Measures administered at pretest and after 10 sessions were: perceived burden (IEQ-EU), knowledge about the disorder (WFBBPS-A) and quality of life (WHOQOL-BREF). For formative evaluation, a "Group Therapy Session Questionnaire" (participant and therapist version; GTS-A, GTS-T) was used. A total of 33 persons in three groups took part. Pre-post evaluations revealed a significantly lower level of burden and a significantly better knowledge about the disorder after participating in the psychoeducational group. Reduction of burden correlated significantly with the assessment of patients' symptom severity and carers' level of burden at study entry. There was no change in the quality of life. The participants and therapists generally rated the psychoeducational sessions very positively. The highest ratings were found in the sessions about communication skills and coping with crises. Findings indicate that the psychoeducational programme is well accepted and supportive for persons with close relationships to patients with BPD.
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