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

Abstract BACKGROUND Families and close relationships of people living with borderline personality disorder (BPD) show increased levels of psychological distress. Family Connections®, a 12-week group intervention based on the principles of Dialectical Behavioral Therapy, has been designed to provide families with both information about the disorder and emotional regulation skills. It has been progressively implemented in French-speaking European countries. METHODS We conducted an observational, multicenter study in France and Switzerland. 149 participants to the Family Connections program were included among 5 centers. Burden, depression, coping, and emotional regulation were assessed before and after intervention. RESULTS T-tests showed that burden significantly decreased after intervention (p<0.0001, d=-0.48), as did depressive symptoms (p<0.001, d=-0.36). Emotional regulation (p<0.0001, d=0.32) and coping (p<0.0001, d=0.53) improved. Two-way mixed ANOVA showed that burden reduction was stronger among women participants compared to men participants (p=0.048, η²=0.027). Before intervention, burden was higher for women participants (p=0.001) than for men. A first linear regression showed that reduction of burden was associated with decrease in resignation of participants (β=0.19, p=0.047). A second linear regression showed that reduction of burden was associated with intensity of the loved one’s symptoms and improvement of emotional clarity of participants (β=0.25, p=0.008). CONCLUSION This Dialectical Behavioral Therapy-Based psychoeducational intervention is an appropriate way to support French-speaking European families of people with BPD.