The effectiveness of group skills training for women with borderline personality disorder

[摘要] English: From the available literature, it is a well-known fact that individuals withBorderline Personality Disorder (BPD) are particularly difficult to treat andrepresent a true challenge to the motivation of any clinician or therapist. Withthis in mind and also taking into consideration the prevailing negative attitudetoward borderline individuals, Linehan lay the grounds for Dialectical BehaviourTherapy (DBT) in the early 1980's. She proposed a treatment approach thatwould help alleviate the pain experienced by borderline individuals, promote thelearning of vital behavioural and problem solving skills, and provide a supportiveand encouraging environment. At the same time the emotional resources of thetherapist would also be safeguarded. DBT is presently an empiricallyresearched treatment approach that delivers highly satisfactory results and isalso being used in the treatment of other major disorders. The goal of this study is to determine whether DBT group skills training iseffective in improving the self esteem and reducing specific problematicbehaviours - impulsivity and self-destructiveness - of women with a diagnosisof BPD in an inpatient setting. The following hypothesis has been formulated:Female patients diagnosed with BPD and having participated in DBTgroup skills training are more likely to demonstrate improved selfesteem,diminished self-destructiveness and lower impulsivity thanfemale BPD patients not having participated in DBT group skillstraining. A study of BPD is made in order to understand the complexities underlying thedisorder. The most common therapeutic approaches to the treatment of BPDare outlined and reviewed in order to highlight the weight DBT brings to the fieldas an empirically researched therapy. The theoretical framework of DBT isdiscussed in depth in order to understand the rationale of the group skillstraining and to underline the impact a shift in paradigm can have in therapeutic outcomes. Finally, the targeted behaviours of the study are discussed as coreaspects of BPDThe research methodology and the results are described. A total of 40inpatients of Tara Hospital, Johannesburg, participated in the research. Theabove stated hypothesis was investigated by means of the Hotelling T2-test todetermine whether there were significant differences between the experimentalgroup and the control group with respect to the four dependent variables - selfesteem,self-destructiveness, impulsive urge, impulsive action - at the threeevaluation times - admission, discharge, one-month follow-up. Significantdifferences between the groups were only found at the one-month follow-upevaluation and these were then further analysed by means of the t-test forindependent groups. The results of the study indicated that, although individuals from both groupsshowed improved symptoms at the time of their discharge, only those whoparticipated in the DBT group skills training were able to maintain theimprovements over a one-month period. Thus, it can be concluded that DBTwas more effective than the general ward program in targeting the specificproblems afflicting the borderline individuals and in offering the appropriateskills to deal with such problems.If borderline individuals are equipped with better skills to effectively deal withand control their self-destructive and impulsive inclinations, then the therapists'emotional resources will not be continuously drained and thus motivation andwillingness to work with borderline individuals will increase. Also, with effectivetreatment, medical costs will also be reduced.In conclusion, this study has shown the importance and necessity of furtherresearch on BPD in South Africa, as there appears to be a lack of localinformation and data on this population group.

[发布机构] University of the Free State