Effective therapeutic components in Systems Training for Emotional Predictability and Problem Solving (STEPPS) for borderline personality disorder.

The study aimed to examine the relative contribution to borderline personality disorder (BPD) symptom change of two potential effective therapeutic components in a manualized group psychotherapy (Systems Training for Emotional Predictability and Problem Solving; STEPPS): development of emotional/behavior regulation skills and group alliance. A repeated measures design assessed BPD symptom change over time, use of behavior and emotion regulation skills taught in STEPPS, and perceptions of global alliance within the group. Data were analyzed using hierarchical multiple regression. Additional qualitative feedback was analyzed using quantitative content analysis. Data were collected from 14 STEPPS groups across three NHS Trusts. Forty participants completed the study and were included in the final analysis. Self-reported skill acquisition throughout STEPPS treatment and satisfaction with intragroup relationships at the group midpoint were associated with improvement in BPD symptoms at the end of treatment, once symptoms at the start and mid-point of treatment had been controlled for. These two factors also emerged as the top two factors cited in qualitative feedback to explain subjective improvements observed as a result of STEPPS treatment. This is the first study to investigate and find support for acquisition of emotion and behavior regulation skills in STEPPS and satisfaction with intragroup relationships as potential effective therapeutic components in the treatment. Causal relationships cannot be concluded from this study. (PsycInfo Database Record (c) 2023 APA, all rights reserved).