Stages of change in dialectical behaviour therapy for borderline personality disorder.
OBJECTIVE
The study aims at evaluating the suitability of applying the transtheoretical model (TTM) stage-of-change construct to the treatment with dialectical behaviour therapy (DBT) of borderline personality disorder (BPD).


METHODS
Stages of change were assessed by means of the University of Rhode Island Change Assessment (URICA) scale prior to and after 3 months DBT skills group psychotherapy.


METHODS
The sample was comprised of 79 people with BPD (86% of females) at pre-treatment, and 42 patients (80% of females) at post-treatment. All patients were referred from clinical services and diagnosed by means of two semi-structured interviews.


RESULTS
In pre-treatment assessment, precontemplation scores correlated significantly and negatively with the other subscales (contemplation, action, and maintenance) and these three subscales also correlated significantly and positively with each other. The precontemplation stage was directly related to drop-out from the DBT group. The action subscale and the committed action (CA) composite score were significantly higher by the end of the DBT group treatment. However, with the absence of a control group it cannot be assured that these increases were directly related to DBT intervention.


CONCLUSIONS
In this observational design the stages of change of TTM seemed applicable to the DBT conceptualization of BPD and could further our understanding of the process of change in people with BPD treated with DBT.
Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. jsolerri@santpau.es
Joaquim
J
Soler
Joan
J
Trujols
Juan Carlos
JC
Pascual
Maria J
MJ
Portella
Judith
J
Barrachina
Josefa
J
Campins
Rosa
R
Tejedor
Enrique
E
Alvarez
Victor
V
Pérez
D001521:Behavior Therapy / Q000379:methods*; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D019370:Observation / Q000379:methods; D010352:Patient Dropouts; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D013811:Psychotherapeutic Processes; D011615:Psychotherapy, Group / Q000379:methods; D012107:Research Design; D016896:Treatment Outcome