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Ekiz E, van Alphen SPJ, Ouwens MA, Van de Paar J, Videler AC. Systems Training for Emotional Predictability and Problem Solving for borderline personality disorder: A systematic review. Personal Ment Health 2023; 17:20-39. [PMID: 35729869 DOI: 10.1002/pmh.1558] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/06/2022] [Accepted: 06/10/2022] [Indexed: 11/11/2022]
Abstract
Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment program for patients with borderline personality disorder (BPD). The program was intended to be highly accessible, both for patients and therapists. During STEPPS, patients are taught emotion regulation and behavior management skills. This systematic review synthesizes the current empirical status of STEPPS, focusing on research designs, quality of studies, target groups, protocols, and outcome. We selected 20 studies, with three randomized controlled trials. Patients with BPD, subthreshold BPD, and patients with BPD and comorbid antisocial personality disorder were investigated. One study was conducted in adolescents. There were no studies in older adults. Results demonstrated STEPPS to be associated with reduced BPD symptoms, improved quality of life, decreased depressive symptoms, and decreased negative affectivity. Mixed results were found for impulsivity and suicidal behaviors. STEPPS has both been studied as an add-on therapy to patients' ongoing treatment, and, with the addition of individual STEPPS sessions, as a stand-alone treatment. High attrition rates were found in patients attending STEPPS, complicating the generalizability of the results. Although the evidence for STEPPS is promising, further research is needed before firm conclusions can be drawn. Recommendations for future research are discussed.
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Affiliation(s)
- Erol Ekiz
- PersonaCura, Clinical Center of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, The Netherlands.,Tranzo, Scientific Centre for Care and Wellbeing of the Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Sebastiaan P J van Alphen
- Tranzo, Scientific Centre for Care and Wellbeing of the Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,Clinical Center of Excellence for Personality Disorders in Older Adults, Mondriaan Mental Health Center, Heerlen-Maastricht, The Netherlands.,Personality and Psychopathology Research Group (PEPS), Department of Psychology (PE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Machteld A Ouwens
- PersonaCura, Clinical Center of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, The Netherlands.,Tranzo, Scientific Centre for Care and Wellbeing of the Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Jamie Van de Paar
- PersonaCura, Clinical Center of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, The Netherlands
| | - Arjan C Videler
- PersonaCura, Clinical Center of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, The Netherlands.,Tranzo, Scientific Centre for Care and Wellbeing of the Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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