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

English: From the available literature, it is a well-known fact that individuals with Borderline Personality Disorder (BPD) are particularly difficult to treat and represent a true challenge to the motivation of any clinician or therapist. With this in mind and also taking into consideration the prevailing negative attitude toward borderline individuals, Linehan lay the grounds for Dialectical Behaviour Therapy (DBT) in the early 1980's. She proposed a treatment approach that would help alleviate the pain experienced by borderline individuals, promote the learning of vital behavioural and problem solving skills, and provide a supportive and encouraging environment. At the same time the emotional resources of the therapist would also be safeguarded. DBT is presently an empirically researched treatment approach that delivers highly satisfactory results and is also being used in the treatment of other major disorders. The goal of this study is to determine whether DBT group skills training is effective in improving the self esteem and reducing specific problematic behaviours - impulsivity and self-destructiveness - of women with a diagnosis of BPD in an inpatient setting. The following hypothesis has been formulated: Female patients diagnosed with BPD and having participated in DBT group skills training are more likely to demonstrate improved selfesteem, diminished self-destructiveness and lower impulsivity than female BPD patients not having participated in DBT group skills training. A study of BPD is made in order to understand the complexities underlying the disorder. The most common therapeutic approaches to the treatment of BPD are outlined and reviewed in order to highlight the weight DBT brings to the field as an empirically researched therapy. The theoretical framework of DBT is discussed in depth in order to understand the rationale of the group skills training and to underline the impact a shift in paradigm can have in therapeutic outcomes. Finally, the targeted behaviours of the study are discussed as core aspects of BPD The research methodology and the results are described. A total of 40 inpatients of Tara Hospital, Johannesburg, participated in the research. The above stated hypothesis was investigated by means of the Hotelling T2-test to determine whether there were significant differences between the experimental group and the control group with respect to the four dependent variables - selfesteem, self-destructiveness, impulsive urge, impulsive action - at the three evaluation times - admission, discharge, one-month follow-up. Significant differences between the groups were only found at the one-month follow-up evaluation and these were then further analysed by means of the t-test for independent groups. The results of the study indicated that, although individuals from both groups showed improved symptoms at the time of their discharge, only those who participated in the DBT group skills training were able to maintain the improvements over a one-month period. Thus, it can be concluded that DBT was more effective than the general ward program in targeting the specific problems afflicting the borderline individuals and in offering the appropriate skills to deal with such problems. If borderline individuals are equipped with better skills to effectively deal with and control their self-destructive and impulsive inclinations, then the therapists' emotional resources will not be continuously drained and thus motivation and willingness to work with borderline individuals will increase. Also, with effective treatment, medical costs will also be reduced. In conclusion, this study has shown the importance and necessity of further research on BPD in South Africa, as there appears to be a lack of local information and data on this population group.