Implementation of outpatient schema therapy for borderline personality disorder: study design.
BACKGROUND
Schema Therapy (ST) is an integrative psychotherapy based upon a cognitive schema model which aims at identifying and changing dysfunctional schemas and modes through cognitive, experiential and behavioral pathways. It is specifically developed for patients with personality disorders. Its effectiveness and efficiency have been demonstrated in a few randomized controlled trials, but ST has not been evaluated in regular mental healthcare settings. This paper describes the study protocol of a multisite randomized 2-group design, aimed at evaluating the implementation of outpatient schema therapy for patients with borderline personality disorder (BPD) in regular mental healthcare and at determining the added value of therapist telephone availability outside office hours in case of crisis.


METHODS
Patient outcome measures will be assessed with a semi-structured interview and self-report measures on BPD, therapeutic alliance, quality of life, costs and general psychopathology at baseline, 6, 12, 18 and 36 months. Intention-to-treat analyses will be executed with survival analysis for dichotomous variables, and one-sample t-tests and ANCOVAs for continuous variables with baseline as covariate and condition as between group factor. All tests will be two-tailed with a significance level of 5%.


CONCLUSIONS
The study will provide an answer to the question whether ST can be effectively implemented and whether phone support by the therapist has an additional value.


BACKGROUND
The Dutch Cochrane Center, NTR (TC = 1781).
Nadort
Marjon
M
GGZinGeest, Department of Psychiatry and Institute for Research in Extramural Medicine, VU University Medical Center Amsterdam, The Netherlands. m.nadort@ggzingeest.nl
Arntz
Arnoud
A
Smit
Johannes H
JH
Giesen-Bloo
Josephine
J
Eikelenboom
Merijn
M
Spinhoven
Philip
P
van Asselt
Thea
T
Wensing
Michel
M
van Dyck
Richard
R
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000379:methods; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002985:Clinical Protocols; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003419:Crisis Intervention; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D010817:Physician-Patient Relations; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000191:economics / Q000379:methods*; D019114:Remote Consultation; D012107:Research Design; D012944:Social Support; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016896:Treatment Outcome