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Tijdschrift voor Psychiatrie 51 (2009) 5, 291 - 301

New research

The efficacy of the systems training for emotional predictability and problem solving (STEPPS) in the treatment of borderline personality disorder. A randomized controlled

E.B. van Wel, E.H. Bos, M.T. Appelo, E.M. Berendsen, F.C. Willgeroth, M.J.P.M. Verbraak

background The types of treatment for borderline personality disorder devised over the last few decades are often difficult to implement in therapy centres. stepps is a group treatment for this disorder which is easy to implement.
aim To compare the efficacy of stepps supported by limited individual treatment with 'treatment as usual' (tau).
method 79 patients with bpd were randomly assigned to stepps or to tau. Measurements were taken before and after the intervention and at one-year follow-up. Outcome measures were: borderline and general psychiatric symptomatology, suicide attempts, quality of life and use of care services.
results stepps led to a larger reduction in symptoms than did tau, the difference being still significant at follow-up. 70% of patients treated with stepps showed improvement compared to 47% of patients treated with tau. In both treatment groups the percentage of patients who recovered was small. There was no difference in the number of suicide attempts in each group. stepps led to a greater improvement in quality of life than did tau, particularly at follow-up. Care service use seemed about equal.
conclusion The efficacy of treatment for bpd can be improved by the introduction of stepps, which is relatively simple to implement.

keywords group therapy, randomised controlled trial, STEPPS, treatment effect, use of care services