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

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...

Full description

Saved in:

Bibliographic Details
Published in:	BMC psychiatry Vol. 22; no. 1; pp. 89 - 28
Main Authors:	Wibbelink, Carlijn J M, Arntz, Arnoud, Grasman, Raoul P P P, Sinnaeve, Roland, Boog, Michiel, Bremer, Odile M C, Dek, Eliane C P, Alkan, Sevinç Göral, James, Chrissy, Koppeschaar, Annemieke M, Kramer, Linda, Ploegmakers, Maria, Schaling, Arita, Smits, Faye I, Kamphuis, Jan H
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 05-02-2022 BioMed Central BMC
Subjects:	Behavior modification Behavior therapy Borderline personality disorder Borderline Personality Disorder - psychology Care and treatment Clinical trials Cognition & reasoning Comparative analysis Costs Dialectical behavior therapy Dialectical Behavior Therapy - methods Emotional regulation Humans Mental disorders Methods Multicenter Studies as Topic Patients Personality Personality disorders Personalized medicine Psychiatry Psychotherapy Psychotherapy - methods Randomized clinical trial Randomized Controlled Trials as Topic Schema Therapy Study Protocol Suicides & suicide attempts Treatment Outcome Treatment selection Netherlands Mechanisms of change Effectiveness Randomized clinical trial Mediators Treatment selection Dialectical behavior therapy Schema therapy Personalized medicine Borderline personality disorder
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	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. 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. 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). Netherlands Trial Register, NL7699 , registered 25/04/2019 - retrospectively registered.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	1471-244X 1471-244X
DOI:	10.1186/s12888-021-03670-9