Unknown

Dataset Information

0

Towards optimal treatment selection for borderline personality disorder patients (BOOTS): a study protocol for a multicenter randomized clinical trial comparing schema therapy and dialectical behavior therapy.


ABSTRACT:

Background

Specialized evidence-based treatments have been developed and evaluated for borderline personality disorder (BPD), including Dialectical Behavior Therapy (DBT) and Schema Therapy (ST). Individual differences in treatment response to both ST and DBT have been observed across studies, but the factors driving these differences are largely unknown. Understanding which treatment works best for whom and why remain central issues in psychotherapy research. The aim of the present study is to improve treatment response of DBT and ST for BPD patients by a) identifying patient characteristics that predict (differential) treatment response (i.e., treatment selection) and b) understanding how both treatments lead to change (i.e., mechanisms of change). Moreover, the clinical effectiveness and cost-effectiveness of DBT and ST will be evaluated.

Methods

The BOOTS trial is a multicenter randomized clinical trial conducted in a routine clinical setting in several outpatient clinics in the Netherlands. We aim to recruit 200 participants, to be randomized to DBT or ST. Patients receive a combined program of individual and group sessions for a maximum duration of 25 months. Data are collected at baseline until three-year follow-up. Candidate predictors of (differential) treatment response have been selected based on the literature, a patient representative of the Borderline Foundation of the Netherlands, and semi-structured interviews among 18 expert clinicians. In addition, BPD-treatment-specific (ST: beliefs and schema modes; DBT: emotion regulation and skills use), BPD-treatment-generic (therapeutic environment characterized by genuineness, safety, and equality), and non-specific (attachment and therapeutic alliance) mechanisms of change are assessed. The primary outcome measure is change in BPD manifestations. Secondary outcome measures include functioning, additional self-reported symptoms, and well-being.

Discussion

The current study contributes to the optimization of treatments for BPD patients by extending our knowledge on "Which treatment - DBT or ST - works the best for which BPD patient, and why?", which is likely to yield important benefits for both BPD patients (e.g., prevention of overtreatment and potential harm of treatments) and society (e.g., increased economic productivity of patients and efficient use of treatments).

Trial registration

Netherlands Trial Register, NL7699 , registered 25/04/2019 - retrospectively registered.

SUBMITTER: Wibbelink CJM 

PROVIDER: S-EPMC8817780 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

altmetric image

Publications

Towards optimal treatment selection for borderline personality disorder patients (BOOTS): a study protocol for a multicenter randomized clinical trial comparing schema therapy and dialectical behavior therapy.

Wibbelink Carlijn J M CJM   Arntz Arnoud A   Grasman Raoul P P P RPPP   Sinnaeve Roland R   Boog Michiel M   Bremer Odile M C OMC   Dek Eliane C P ECP   Alkan Sevinç Göral SG   James Chrissy C   Koppeschaar Annemieke M AM   Kramer Linda L   Ploegmakers Maria M   Schaling Arita A   Smits Faye I FI   Kamphuis Jan H JH  

BMC psychiatry 20220205 1


<h4>Background</h4>Specialized evidence-based treatments have been developed and evaluated for borderline personality disorder (BPD), including Dialectical Behavior Therapy (DBT) and Schema Therapy (ST). Individual differences in treatment response to both ST and DBT have been observed across studies, but the factors driving these differences are largely unknown. Understanding which treatment works best for whom and why remain central issues in psychotherapy research. The aim of the present stud  ...[more]

Similar Datasets

| S-EPMC11332312 | biostudies-literature
| S-EPMC10635707 | biostudies-literature
| S-EPMC10873472 | biostudies-literature
| S-EPMC8892362 | biostudies-literature
| S-EPMC11775487 | biostudies-literature
| S-EPMC8122286 | biostudies-literature
| S-EPMC5610433 | biostudies-literature
| S-EPMC7451381 | biostudies-literature
| S-EPMC11836029 | biostudies-literature
| S-EPMC4938890 | biostudies-literature