Meaningful Ways of Understanding and Measuring Change for People with Borderline Personality Disorder: A Thematic Analysis

• Published in: Behavioural and cognitive psychotherapy 2018-09, Vol.46 (5), p.528-540
• Main Authors: McCusker, Louise, Turner, Marie-Louise, Pike, Georgina, Startup, Helen
• Format: Article
• Language: English
• Subjects: Adult; Anxiety; Borderline personality disorder; Borderline Personality Disorder - diagnosis; Borderline Personality Disorder - psychology; Collaboration; Diagnosis; Ethics; Female; Focus Groups; Humans; Impulsivity; Male; Mental depression; Meta-analysis; Middle Aged; Outcome Assessment (Health Care); Patient Compliance; Personality; Personality disorders; Psychopathology; Psychotherapy; Qualitative research; Research Article; Researchers; Suicides & suicide attempts; Systematic review; Treatment Outcome
• ISSN: 1352-4658; 1469-1833
• DOI: 10.1017/S1352465818000036

Background: The effective treatment of Borderline Personality Disorder (BPD) presents healthcare providers with a significant challenge. The evidence base remains limited partially due to a lack of professional consensus and service user involvement regarding ways of measuring change. As a result, the limited evidence that is available draws on such a wide range of outcome measures, that comparison across treatment types is hindered, maintaining a lack of clarity regarding the clinical needs of this group. Aims: This investigation aimed to follow the National Institute of Clinical Excellence (NICE, 2009) research recommendations by asking service users about meaningful change within their recovery. This forms a starting point for the future development of a tailored outcome measure. Method: Fifteen service users with a diagnosis of BPD participated in three focus groups across two specialist Personality Disorder services. The focus groups were analysed using Thematic Analysis. Results: Two superordinate themes were synthesized from the data: (1) recovery to what?: ‘How do you rewrite who you are?’; and (2) conditions for change. Each superordinate theme further consisted of three subordinate themes which elucidated the over-arching themes. Conclusion: This investigation highlights the complex nature of measuring change in people who have received a BPD diagnosis. Further research is needed to develop meaningful ways of measuring change according to the needs and priorities of people with BPD.