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Hayes A, Courey L, Kells M, Hyndman D, Dempsey M, Murphy M. Caregivers of individuals with borderline personality disorder: The relationship between leading caregiver interventions and psychological distress/positive mental well-being. FAMILY PROCESS 2024. [PMID: 39091082 DOI: 10.1111/famp.13042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 04/15/2024] [Accepted: 07/08/2024] [Indexed: 08/04/2024]
Abstract
Burden and psychological distress are higher in informal caregivers (ICs) of people with severe emotional and behavior dysregulation who have been given a diagnosis of borderline personality disorder (BPD) compared with non-caregivers. The current cross-sectional study examines the difference in outcomes of ICs of people with BPD who have received the intervention Family Connections (FC) and who also led interventions for other caregivers (caregiver-leaders) compared with those who have attended FC but not led caregiver interventions (non-leader-FC participants). The sample for this research is from a larger study (Hayes et al., 2023, Borderline Personality Disorder and Emotion Dysregulation, 10, 31). Data for 347 participants who self-reported receiving FC and completed the McLean Screening Instrument for BPD-Carer Version, the Brief COPE, the Multidimensional Scale of Perceived Social Support, the Kessler Psychological Distress scale, the WHO-5 Well-being Index, and the Coronavirus Anxiety Scale were analyzed. The results found that being a caregiver-leader was associated with higher positive mental well-being and lower psychological distress compared with non-leader-FC participants. Being a caregiver-leader was also associated with significantly greater use of the coping strategy of positive reframing and lower use of behavioral disengagement and self-blame than non-leader-FC participants. The study provides preliminary evidence that for those who have received FC, becoming an intervention leader is associated with better outcomes than caregivers who do not become leaders and provides support for caregiver-led rollout of FC across services.
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Affiliation(s)
- Aoife Hayes
- School of Applied Psychology, University College Cork, Cork, Ireland
- Mental Health Services, Cork Kerry Community Healthcare, Health Service Executive, Cork, Ireland
| | - Lynn Courey
- The Sashbear Foundation, Toronto, Ontario, Canada
| | - Mary Kells
- Mental Health Services, Cork Kerry Community Healthcare, Health Service Executive, Cork, Ireland
| | | | - Maria Dempsey
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Mike Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
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Cohen S, Salamin V, Perroud N, Dieben K, Ducasse D, Durpoix A, Guenot F, Tissot H, Kramer U, Speranza M. Group intervention for family members of people with borderline personality disorder based on Dialectical Behavior Therapy: Implementation of the Family Connections® program in France and Switzerland. Borderline Personal Disord Emot Dysregul 2024; 11:16. [PMID: 39039536 PMCID: PMC11265349 DOI: 10.1186/s40479-024-00254-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/23/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Families and significant others of people with borderline personality disorder (BPD) show increased levels of psychological distress. Family Connections®, a 12-week group intervention based on the principles of Dialectical Behavior Therapy, was designed to provide families with both information about the disorder and emotion regulation skills. It has been progressively implemented in French-speaking European countries. METHODS We conducted an observational, multicenter study in France and Switzerland. In total, 149 participants of the Family Connections program were included among five centers. Burden, depression, coping, and emotion regulation were assessed before and after the intervention. RESULTS One-way repeated measures MANOVA showed that the burden, depressive symptoms, emotion regulation and coping all changed significantly after the intervention (p < 0.001, partial η2 = 0.297). T-tests showed that the burden significantly decreased after the intervention (p < 0.0001, d = -0.48), as did depressive symptoms (p < 0.0001, d = -0.36) and difficulties in emotion regulation (p < 0.0001, d =-0.32) whereas coping improved (p < 0.0001, d = 0.53). Two-way mixed ANOVA showed that burden reduction was stronger among female than male participants (p = 0.048, η2 = 0.027). Before the intervention, the burden was higher for female than male participants (p < 0.001). An initial linear regression showed the burden reduction to be associated with a decrease in the resignation of the participants (β = 0.19, p = 0.047). A second linear regression showed the burden reduction to be associated with the intensity of the relatives' symptoms at baseline (β = 0.22, p = 0.008) and improvement of emotional clarity of the participants (β = 0.25, p = 0.006). CONCLUSION This Dialectical Behavior Therapy-Based psychoeducational intervention is an appropriate way to support French-speaking European families of people with BPD.
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Affiliation(s)
- Satchel Cohen
- Child and Adolescent Psychiatry Care Unit, Versailles Hospital, Le Chesnay, France.
- Paris-Saclay University, UVSQ, Inserm, Centre for Research in Epidemiology and Population Health UMR 1018, Team "Developmental Psychiatry and Trajectories", 78000, Versailles, France.
| | | | - Nader Perroud
- Department of Psychiatric Specialties for Emotion Regulation Disorders, Geneva University Hospitals, 1201, Geneva, Switzerland
| | - Karen Dieben
- Department of Psychiatric Specialties for Emotion Regulation Disorders, Geneva University Hospitals, 1201, Geneva, Switzerland
| | - Déborah Ducasse
- CHU de Montpellier, Service Urgences Et Post-Urgences Psychiatriques (Lapeyronie), Centre de Thérapies Troubles de L'humeur Et Émotionnels/Borderline (La Colombière), IGF, Univ. Montpellier, CNRS, Inserm, Montpellier, France
| | - Amaury Durpoix
- Strasbourg University Hospital, 67000, Strasbourg, France
| | | | - Hervé Tissot
- Center for Family Studies, University Institute of Psychotherapy, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Ueli Kramer
- Lausanne University Hospital Institute of Psychotherapy/General Psychiatry, 1003, Lausanne, Switzerland
| | - Mario Speranza
- Child and Adolescent Psychiatry Care Unit, Versailles Hospital, Le Chesnay, France.
- Paris-Saclay University, UVSQ, Inserm, Centre for Research in Epidemiology and Population Health UMR 1018, Team "Developmental Psychiatry and Trajectories", 78000, Versailles, France.
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Villet L, Madjlessi A, Revah-Levy A, Speranza M, Younes N, Sibéoni J. The lived experience of French parents concerning the diagnosis of their children with borderline personality disorder. Borderline Personal Disord Emot Dysregul 2024; 11:13. [PMID: 38946002 PMCID: PMC11215819 DOI: 10.1186/s40479-024-00258-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 06/18/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Psychiatrists often hesitate to diagnose borderline personality disorder (BPD). While individuals with BPD have reported both positive and negative experiences upon receiving their diagnosis, no study has specifically explored this issue among parents. Parents of children diagnosed with BPD can benefit from recently developed family-support interventions such as the Family Connections program. Our study aimed to explore the experiences of parents learning about their child's BPD diagnosis and to investigate the impact of the Family Connections program on their experiences. METHODS This qualitative study, conducted in France following the five-stage IPSE method, involved parents of children with BPD recruited through the Family Connections association in Versailles. We conducted semi-structured interviews and used purposive sampling for data collection until data saturation was reached. Data analysis was performed using a descriptive and structuring approach with NVivo 12 software to elucidate the structure of lived experiences. RESULTS The study included 21 parents. The structure of the lived experiences was characterized by three central axes: (1) the long and difficult road to diagnosis; (2) communicating the BPD diagnosis to parents: a necessary step; (3) the pitfalls of receiving the diagnosis. The Family Connections program provided significant support in these areas, particularly in understanding the diagnosis, enhancing communication with their child, and reducing social isolation. CONCLUSION These findings highlight the challenges parents face when receiving a BPD diagnosis for their child and underscore the need for an early, clear, and detailed explanation of the diagnosis. The specific experiences of receiving the diagnosis are indicative of the broader care experience parents undergo and highlight their need and right to be informed, supported, and guided throughout their child's treatment.
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Affiliation(s)
- Léa Villet
- Service de psychopathologie de l'enfant et de l'adolescent, Hôpitaux de Saint Maurice, 63 rue de la Roquette, Paris, 75011, France.
| | - Abtine Madjlessi
- Service de psychiatrie adulte, Hôpital François Quesnay, Mantes-la-Jolie, 78200, France
| | - Anne Revah-Levy
- Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, 95100, France
- ECSTRRA Team, UMR-1153, Université Paris Cité, Inserm, Paris, 75010, France
| | - Mario Speranza
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier de Versailles, 177 Rue de Versailles, Le Chesnay‑Rocquencourt, 78150, France
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP), INSERM UMR 1018 «Developmental Psychiatry and Trajectories», Université Paris-Saclay, Université Versailles Saint Quentin en Yvelines, 16 Av. Paul Vaillant Couturier, Villejuif, 94800, France
| | - Nadia Younes
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP), INSERM UMR 1018 «Developmental Psychiatry and Trajectories», Université Paris-Saclay, Université Versailles Saint Quentin en Yvelines, 16 Av. Paul Vaillant Couturier, Villejuif, 94800, France
- Service Universitaire de Psychiatrie pour adultes et addictologie, Centre Hospitalier de Versailles, 177 rue de Versailles, Le Chesnay-Rocquencourt, 78150, France
- Université de Versailles, Saint -Quentin en Yvelines, Versailles, France
| | - Jordan Sibéoni
- Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, 95100, France
- ECSTRRA Team, UMR-1153, Université Paris Cité, Inserm, Paris, 75010, France
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Ekdahl S, Carlson E, Idvall E, Perseius KI. Need of support for significant others to persons with borderline personality disorder-A Swedish focus group study. Scand J Caring Sci 2024; 38:240-248. [PMID: 37846882 DOI: 10.1111/scs.13221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/08/2023] [Accepted: 09/23/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Being a significant other (SO) to a person with borderline personality disorder (BPD) affect their health. High incidence of substance use disorder, post-traumatic stress disorder, stress, fear, anxiety, depression, family burden and grief are common. Some specific therapies for BPD, have included support to SOs, however resources are scarce and to participate in the support it assumes that the person with BPD is included in these therapies. Although the SO support has been shown to be helpful, they all have a similar structure, and only a small exclusive group of SOs have access to the support. AIM The aim was to describe experiences and need of support for significant others to persons with borderline personality disorder from the perspective of themselves and of health care workers. METHODS Data was collected via two focus groups. One with five SOs to persons with BPD, one with five health care workers. Two interview sessions in each group were conducted and data were analysed with qualitative content analysis. The study was approved by the research ethics committee of Lund (2016-1026). RESULTS The results revealed four themes; not being seen by health care professionals creates hopelessness, being seen by healthcare professionals creates trust, experience of support - helpful or shameful and the step from loosely structured support to a structured support group. Both groups expressed a need for further support as a complement to already existing support. CONCLUSIONS The need of support is extensive. The results suggest a professional coordinator intended for SOs and peer support groups not linked to a particular psychiatric treatment yet offering support in a structured way. Further studies examining these complements to existing support, is therefore recommended.
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Affiliation(s)
- Susanne Ekdahl
- Nyckeln Competence Center, Kalmar County Hospital, Kalmar, Sweden
- Department of Care Science, Malmö University, Malmö, Sweden
| | | | - Ewa Idvall
- Department of Care Science, Malmö University, Malmö, Sweden
| | - Kent-Inge Perseius
- Department of Health and Caring Science, Linnaeus University, Kalmar, Sweden
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Hultsjö S, Appelfeldt Å, Wärdig R, Cederqvist J. Don´t set us aside!Experiences of families of people with BPD who have access to Brief admission:a phenomenological perspective. Int J Qual Stud Health Well-being 2023; 18:2152943. [PMID: 36476045 PMCID: PMC9733683 DOI: 10.1080/17482631.2022.2152943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AIM To highlight the experiences of family members of people with borderline personality disorder (BPD) and self-harming behaviour who have access to brief admission. METHODS To understand the families lived experience a phenomenological lifeworld perspective was adopted to this study. Twelve in-depht interviews were performed in November and December 2021 with family members of people with BPD and self-harming behaviour who have accessed BA. The phenomenological life-world perspective guided the analysis. RESULTS Families' life-world was characterized by anxiety and constant protection of their loved one. They live with constant fear of how their loved ones are feeling and whether they will injure themselves. When access to BA was available this gave hope and provided conditions for families to maintain everyday routines and also enhanced relationships among family members. When families' loved ones were denied BA, they felt betrayed which contributed to negative feelings towards the medical profession, and the families lost confidence in psychiatry. CONCLUSION By interviewing families of people with BPD and self-harming behaviour who had access to BA, it emerged they possess valuable knowledge. BA can be developed if the needs of families are taken into consideration, and if families are given the opportunity to share emotions and the high burden of responsibility with staff or families in similar situations. If health care staff gives family members a more central role in care and makes their shared life-world visible it could thereby hopefully increase well-being and benefits for the whole family.
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Affiliation(s)
- Sally Hultsjö
- Department of Psychiatry, Ryhov County Hospital. Jönköping, Sweden and Department of Health, Medicine and Caring Sciences. Division of Nursing and Reproductive Health, Linköping University, Linköping, Sweden,CONTACT Sally Hultsjö House N2, Department of Psychiatry, Ryhov County Hospital. 551 85 Jönköping, Sweden
| | - Åsa Appelfeldt
- Department of Psychiatry, Ryhov County Hospital. Jönköping, Sweden and Department of Health, Medicine and Caring Sciences. Division of Nursing and Reproductive Health, Linköping University, Linköping, Sweden
| | - Rikard Wärdig
- Department of Health, Medicine and Caring Sciences. Division of Nursing and Reproductive Health, Linköping University, Linköping, Sweden
| | - Jessica Cederqvist
- Department of Psychiatry, Ryhov County Hospital. Jönköping, Sweden and Department of Health, Medicine and Caring Sciences. Division of Nursing and Reproductive Health, Linköping University, Linköping, Sweden
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Fonseca-Baeza S, García-Alandete J, Marco JH, Pérez Rodríguez S, Baños RM, Guillén V. Difficulties in emotional regulation mediates the impact of burden on quality of life and mental health in a sample of family members of people diagnosed with Borderline Personality Disorder. Front Psychol 2023; 14:1270379. [PMID: 38054179 PMCID: PMC10694221 DOI: 10.3389/fpsyg.2023.1270379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/06/2023] [Indexed: 12/07/2023] Open
Abstract
Background Although it has been suggested that family members of persons suffering from Borderline Personality Disorder (BPD) endure high levels of burden, however, the process and the impact of this burden in their lives, and specifically the relation between the burden and emotional regulation has not been broadly investigated among this population. The main objective of this study is to examine the impact of burden on quality of life and depression, anxiety and stress, as mediated by difficulties in emotional regulation in family members of persons diagnosed with BPD. Method Participants were 167 family members of persons diagnosed with BPD. The Burden Assessment Scale, Difficulties in Emotion Regulation Scale, Multicultural Quality of Life Index, and Depression Anxiety Stress Scale-21 were filled out. Mediation analysis was conducted using the Maximum Likelihood estimator, bootstrap method and listwise deletion for missing data. Results Burden showed a significant, negative effect on quality of life and positive on depression, anxiety and stress. Difficulties in emotion regulation significantly mediated these relations. After accounting for the mediating role of difficulties in emotion regulation, burden still had an impact on quality of life, depression, anxiety and stress. Women showed a higher level in both burden and stress than men. The caregivers with secondary and higher studies showed higher levels in burden than those with no studies. Not significant differences in burden, emotion regulation, depression, anxiety and stress were found related to marital status. Conclusion Difficulties in emotion regulation mediate the relations between burden and quality of life, depression, anxiety, and stress. Family members could engage in group interventions designed specifically for family members of people with BPD, oriented toward understanding the disorder or learning skills.
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Affiliation(s)
- Sara Fonseca-Baeza
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Joaquín García-Alandete
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - José Heliodoro Marco
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Sandra Pérez Rodríguez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Rosa M. Baños
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Verónica Guillén
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
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Hayes A, Dempsey M, Kells M, Murphy M. The relationship between social support, coping strategies and psychological distress and positive mental well-being in carers of people with borderline personality disorder. Borderline Personal Disord Emot Dysregul 2023; 10:31. [PMID: 37821995 PMCID: PMC10568807 DOI: 10.1186/s40479-023-00237-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/14/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Informal carers of people with BPD experience high levels of burden and psychological distress relative to other populations. There is a scarcity of research evidencing the influence of modifiable factors on carer outcomes to inform interventions. This study aimed to investigate the relationship between social support, coping strategies and psychological distress and positive mental well-being in this carer population. METHODS In this cross-sectional study, 1207 carers completed the McLean Screening Instrument for BPD-Carer Version, the Brief COPE, the Multidimensional Scale of Perceived Social Support, the Kessler Psychological Distress scale, the WHO-5 Well-being Index, and the Coronavirus Anxiety Scale. Data for 863 participants who met the inclusion criteria were analysed. RESULTS Carers reported low positive mental well-being and high psychological distress. Perceived social support and several coping strategies were significant unique predictors of psychological distress and positive mental well-being. Perceived social support and positive reframing were the strongest predictors of higher positive mental well-being and lower psychological distress. Self-blame, behavioural disengagement and substance use were the strongest predictors of adverse outcomes. CONCLUSIONS The findings evidence modifiable factors that may be used to improve informal carer outcomes and indicate that carer interventions may be improved by focusing on reducing the use of self-blame, behavioural disengagement and substance use, and development of quality social support and skills to positively reframe caregiving situations.
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Affiliation(s)
- Aoife Hayes
- School of Applied Psychology, University College Cork, Cork, Ireland.
| | - Maria Dempsey
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Mary Kells
- Mental Health Services, Cork Kerry Community Healthcare, Health Service Executive, Cork, Ireland
| | - Mike Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
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Chironda G, Jarvis MA, Brysiewicz P. Family-Focused Nursing Research in WHO Afro-Region Member States: A Scoping Review. JOURNAL OF FAMILY NURSING 2023; 29:136-154. [PMID: 36433834 PMCID: PMC10160405 DOI: 10.1177/10748407221132018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Although family nursing research has become an important focus for over the past 20 years, the evolution and extent of family nursing research in the World Health Organization (WHO) Afro-regions is less explored. The purpose of this scoping review was to map the evidence of family-focused nursing research using the Joanna Briggs Institute Scoping Review methodology. A systematic electronic search of articles was carried out for the period January 1, 2000 to December 31, 2020. The review process culminated in 85 articles, evidencing an increase in publications particularly in 2019 (n = 12). Eighteen countries were involved, with the Southern African region contributing 52% of the studies. Family members were predominantly described as parents, siblings, and children, with the most focused area of study being family experiences (n = 52). The majority of studies (n = 59) used qualitative methodologies. Despite the recent increase in family-focused nursing research in the WHO Afro-regions, further qualitative research, including more complex methodologies and interventions are still required to build contextualized evidence-based family-focused nursing.
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García-Alandete J, Fernández-Felipe I, Fonseca-Baeza S, Fernández I, Pérez S, Marco JH, Guillén V. Spanish adaptation of the Burden Assessment Scale in family caregivers of people diagnosed with borderline personality disorder. Borderline Personal Disord Emot Dysregul 2023; 10:6. [PMID: 36800981 PMCID: PMC9940418 DOI: 10.1186/s40479-023-00211-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/26/2023] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND Caregiving is a strong source of stress and leads the family caregiver to experience the burden of being responsible for the care of a severely mentally ill family member. The Burden Assessment Scale (BAS) assesses burden in family caregivers. This study aimed to analyze the psychometric properties of the BAS in a sample of family caregivers of people diagnosed with Borderline Personality Disorder (BPD). METHODS Participants were 233 Spanish family caregivers (157 women and 76 men aged between 16-76 years old, M = 54.44, SD = 10.09) of people diagnosed with BPD. The BAS, the Multicultural Quality of Life Index, and the Depression Anxiety Stress Scale-21 were used. RESULTS An exploratory analysis resulted in a three-factor 16-item model (Disrupted Activities; Personal and Social Dysfunction; Worry, Guilt, and Being Overwhelmed) with an excellent fit (χ2(101) = 56.873, p = 1.000, CFI = 1.000, TLI = 1.000, RMSEA = .000, SRMR = .060), good internal consistency (ω = .93), a negative correlation with quality of life, and a positive correlation with anxiety, depression, and stress. CONCLUSION The model obtained for the BAS is a valid, reliable, and useful tool for assessing burden in family caregivers of relatives diagnosed with BPD.
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Affiliation(s)
- Joaquín García-Alandete
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Avda. Blasco Ibáñez, 21, 46010, Valencia, Spain.
| | - Isabel Fernández-Felipe
- Department of Basic and Clinical Psychology and Psychobiology, University Jaume I, Avda. Vicent Sos Baynat, S/N. 12071, Castellón de La Plana, Spain
| | - Sara Fonseca-Baeza
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Avda. Blasco Ibáñez, 21, 46010, Valencia, Spain
| | - Irene Fernández
- Department of Behavioral Sciences Methodology, University of Valencia, Avda. Blasco Ibáñez, 21. 46010, Valencia, Spain
| | - Sandra Pérez
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Avda. Blasco Ibáñez, 21, 46010, Valencia, Spain
| | - José H Marco
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Avda. Blasco Ibáñez, 21, 46010, Valencia, Spain.,CIBER Physiopathology, Obesity and Nutrition (CB06/03), Carlos III Health Institute, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - Verónica Guillén
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Avda. Blasco Ibáñez, 21, 46010, Valencia, Spain.,CIBER Physiopathology, Obesity and Nutrition (CB06/03), Carlos III Health Institute, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain
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10
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Guillén V, Fonseca-Baeza S, Fernández-Felipe I, Botella C, Baños R, García-Palacios A, Marco J. Effectiveness of family connections intervention for family members of persons with personality disorders in two different formats: Online vs face-to-face. Internet Interv 2022; 28:100532. [PMID: 35646607 PMCID: PMC9136357 DOI: 10.1016/j.invent.2022.100532] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Personality disorders (PD) have a serious impact on the lives of individuals who suffer from them and those around them. It is common for family members to experience high levels of burden, anxiety, and depression, and deterioration in their quality of life. It is curious that few interventions have been developed for family members of people with PD. However, Family Connections (FC) (Hoffman and Fruzzetti, 2005) is the most empirically supported intervention for family members of people with Borderline Personality Disorder (BPD). AIM The aim of this study is to explore the effectiveness of online vs face-to-face FC. Given the current social constraints resulting from SARS-CoV-2, interventions have been delivered online and modified. METHOD This was a non-randomized pilot study with a pre-post evaluation and two conditions: The sample consisted of 45 family members distributed in two conditions: FC face-to-face (20) performed by groups before the pandemic, and FC online (25), performed by groups during the pandemic. All participants completed the evaluation protocol before and after the intervention. RESULTS There is a statistically significant improvement in levels of burden (η 2 = 0.471), depression, anxiety, and stress (η 2 = 0.279), family empowerment (η 2 = 0.243), family functioning (η 2 = 0.345), and quality of life (μ2 η 2 = 0.237). There were no differences based on the application format burden (η 2 = 0.134); depression, anxiety, and stress (η 2 = 0.087); family empowerment (η 2 = 0,27), family functioning (η 2 = 0.219); and quality of life (η 2 = 0.006), respectively). CONCLUSIONS This study provides relevant data about the possibility of implementing an intervention in a sample of family members of people with PD in an online format without losing its effectiveness. During the pandemic, and despite the initial reluctance of family members and the therapists to carry out the interventions online, this work shows the effectiveness of the results and the satisfaction of the family members. These results are particularly relevant in a pandemic context, where there was no possibility of providing help in other ways. All of this represents a great step forward in terms of providing psychological treatment.
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Affiliation(s)
- V. Guillén
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain,Corresponding author at: Dep. of Personality, Evaluation and Psychological Treatments, University of Valencia, Av. Blasco Ibañez 21, 46010, Spain.
| | | | - I. Fernández-Felipe
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - C. Botella
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - R. Baños
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - A. García-Palacios
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - J.H. Marco
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
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Shimange ME, Poggenpoel M, Myburgh CP, Ntshingila N. Lived experiences of family members caring for a relative with mental illness. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Fernández-Felipe I, Díaz-García A, Marco JH, García-Palacios A, Guillén Botella V. "Family Connections", a DBT-Based Program for Relatives of People with Borderline Personality Disorder during the COVID-19 Pandemic: A Focus Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010079. [PMID: 35010344 PMCID: PMC8750943 DOI: 10.3390/ijerph19010079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 05/28/2023]
Abstract
The COVID-19 pandemic has had a significant impact on the family environment due to the difficulties that have been generated by job losses, deaths, increase rates of family and domestic violence, poor mental health outcomes, and estrangement in personal relationships. "Family Connections" (FC) is an internationally renowned DBT-based program that supports the families and caregivers of people with borderline personality disorder. The study took place at a Specialized Health Centre in Spain. A focus group with seven participants was organized for people who had previously attended an FC group. The participants were asked about their experiences during the confinement periods that was caused by COVID-19 as well as their experiences and opinions on relatives, skills practiced, their need to and the advantages of attending the group, and satisfaction with the FC group. The qualitative research web program Dedoose was used for the thematic analysis of the data. The results showed that the participants experienced various experiences during confinement; validation and radical acceptance were determined to be the most useful skills; the importance of professionals and the content as well as the sincerity of attendees and having a safe space were determined to be the greatest benefits of the programs; and the participants all indicated great satisfaction of the program. This study allowed us to explore the experiences of family members of people with BPD with their loved ones during the confinement period caused by the COVID-19 pandemic. We evaluated the use of the FC program skills in the family environment during confinement, and we analyzed the acceptability and satisfaction with the FC program.
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Affiliation(s)
- Isabel Fernández-Felipe
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, 12071 Castellón, Spain;
| | - Amanda Díaz-García
- Department of Psychology and Sociology, Universidad de Zaragoza, 44003 Teruel, Spain;
| | - José Heliodoro Marco
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universitat de Valencia, 46010 Valencia, Spain; (J.H.M.); (V.G.B.)
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, 12071 Castellón, Spain;
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Verónica Guillén Botella
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universitat de Valencia, 46010 Valencia, Spain; (J.H.M.); (V.G.B.)
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, 28029 Madrid, Spain
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What we know - and want to know - about Family Connections: a review from the perspective of lived experience. Curr Opin Psychol 2020; 37:44-48. [PMID: 32829003 DOI: 10.1016/j.copsyc.2020.07.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/28/2020] [Indexed: 01/24/2023]
Abstract
Family Connections is a peer-led education, skills, and support program for family members of individuals with borderline personality disorder. Extant literature on Family Connections is limited but consistent in regard to methodology and outcomes, allowing for meaningful cross-study comparison. Despite evidence across studies regarding the program's efficacy, a number of questions remain to be answered. Three possible future research directions were identified from the perspective of family members with lived experience who are also Family Connections peer leaders; examining Family Connections when led by peers, gathering qualitative data about family member's experiences of Family Connections to illuminate additional program benefits, and studying the efficacy of Family Connections for family members of those with other mental health disorders.
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Martin K, Holz T, Woodward G, Cameron M. Exploring the Impact of a Peer-Led Education Group for Loved Ones of Individuals with Borderline Personality Disorder: A Pilot Study. CONTEMPORARY FAMILY THERAPY 2020. [DOI: 10.1007/s10591-020-09543-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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