Abstract
The authors report the results of a pilot project to introduce the STEPPS (systems training for emotional predictability and problem solving) treatment program for persons with borderline personality disorder (BPD) to the United Kingdom. STEPPS combines cognitive-behavioral principles and skills training with a systems component that includes family members and significant others. STEPPS was developed to supplement the patient’s ongoing treatment program (e.g. medication, individual therapy, case management) and boost its effectiveness, but not replace it. Thirty-eight subjects agreed to participate at six sites in West Sussex, England. A pre- and post-intervention comparison design was used, and over the 20 week program were found to have significant improvement in their mood, BPD-related symptoms (including affective, cognitive, and impulsive domains), and both negative and positive affectivity. Subjects reported high levels of satisfaction with the program. This study provides further evidence that STEPPS, a relatively brief fully manualized group treatment program, may be used in other countries and achieves high levels of acceptance from patients and therapists.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bartels, N., & Crotty, T. (1998). A systems approach to treatment: The borderline personality disorder skill training manual. Winfield: EID Treatment Systems.
Bateman, A., & Fonagy, P. (2008). 8-year follow-up of patients treated for borderline personality disorder: Mentalization-based treatment versus treatment as usual. American Journal of Psychiatry, 165, 631–638.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio: Psychological corporation.
Ben-Porath, D. D., Peterson, G. A., & Smee, J. (2004). Treatment of individuals with borderline personality disorder using dialectical behavior therapy in a community mental health setting: Clinical application and a preliminary investigation. Cognitive and Behavioral Practice, 11, 424–434.
Black, D. W., Blum, N., Pfohl, B., & St. John, D. (2004). The STEPPS group treatment program for outpatients with borderline personality disorder. Journal of Contemporary Psychotherapy, 34, 193–210.
Blum, N., Allen, J., McCormick, B., & Black, D. W. (2008a). Blum and colleagues reply to Schutte-Herbruggen et al. American Journal of Psychiatry, 10, 1354–1355.
Blum, N., Bartels, N., St. John, D., & Pfohl, B. (2002a). STEPPS: Systems training for emotional predictability and problem solving: Group treatment for borderline personality disorder. Coralville: Blum’s Books.
Blum, N., Pfohl, B., St. John, D., Monahan, P., & Black, D. W. (2002b). STEPPS: A cognitive behavioral systems-based group treatment for outpatients with borderline personality disorder—a preliminary report. Comprehensive Psychiatry, 43, 301–310.
Blum, N., St. John, D., Pfohl, B., Stuart, S., McCormick, B., Allen, J., et al. (2008b). Systems training for emotional predictability and problem solving (STEPPS) for outpatients with borderline personality disorder: A randomized controlled trial and 1-year follow-up. American Journal of Psychiatry, 165, 468–478.
Connell, J., & Barkham, M. (2007). Core-10 User Manual, Version 1.1. Core System Trust & Core Information Management Systems Ltd., Rugby, UK.
Fraser, J. S., & Solovey, A. D. (2006). Second-order change in psychotherapy: The golden thread that unifies effective treatments. New York: Am Psychol Assoc.
Freije, H., Dietz, B., & Appelo, M. (2002). Behandeling van de borderline persoonlijkheidsstoornis met de Vers: de Vaardigheidstraining emotionele regulatiestoornis. Directive Therapies, 4, 367–378.
Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford.
National Institute for Clinical Guidance (NICE). 2009. Borderline Personality Disorder, http://www.nice.org.uk/guidance/index.jsp?action=folder&o=40839.
Pfohl, B., Blum, N., McCormick, B., St. John, D., Allen, J., & Black, D. W. (2009). Reliability and validity of the borderline evaluation of severity over time: A new scale to measure severity and change in borderline personality disorder. Journal of Personality Disorders, 23, 281–293.
Reisner, A. D. (2005). The common factors, empirically validated treatments, and recovery models of therapeutic change. The Psychological Record Gambier, 55(3), 377–399.
Robins, C. J., & Chapman, A. L. (2004). Dialectical behavior therapy: Current status, recent developments, and future directions. Journal of Personality Disorders, 18(1), 73–89.
Scheel, K. R. (2000). The empirical casis of Dialectical Behavior Therapy: Summary, critique, and implications. Clinical Psychology: Science and Practice, 7(1), 68–86.
Schulte-Herburggen, O., Koerting, J., & Roepke, S. (2008). Effectiveness of adjunctive STEPPS group treatment in borderline personality disorder patients. American Journal of Psychiatry, 165, 1354–1355.
Van Wel, B., Bos, E. H., Appelo, M. T., Berendsen, E. M., Willgeroth, F. C., & Verbraak, M. J. P. M. (2009). De effectiviteit van de vaardigheidstraining Emotieregulatiestoornis (VERS) in de behandeling van de Borderlinepersoonlijkheidsstoornis; een gerandomiseerd onderzoek. Tijdschrift voor psychiatrie, 51, 5.
Van Wel, B., Kockmann, I., Blum, N., Pfohl, B., Black, D. W., & Heesterman, W. (2006). STEPPS group treatment for borderline personality disorder in The Netherlands. Annals of Clinical Psychiatry, 18, 63–67.
Watson, D., & Clark, A. L. (1994). The PANAS-X: Manual for the positive and negative affect schedule—Expanded Form. IA: University of Iowa.
Wilson, S. B. (2006). Heightened subjective experience of depression in borderline personality disorder. Journal of Personality Disorder, 20(4), 307–318.
Yeomans, F. E., Gutfreund, J., Selzer, M. A., Clarkin, J. F., Hull, J. W., & Smith, T. E. (1994). Factors related to drop-outs by borderline patients. Journal of Psychotherapy Practice and Research, 3, 16–24.
Zanarini, M. C. (2003). Zanarini rating scale for borderline personality disorder (ZAN-BPD) a continuous measure of DSM-IV borderline psychopathology. Journal of Personality Disorders, 17, 233–242.
Acknowledgments
This work was supported by the South East Research and Development Support Unit, Brighton, England, UK. The authors thank Lydia Turner, Mark Hayward, Mel Baird, Vinca Crofts, Debbie Bull, Lesley Charnick, Linda Doel, Pat Lawes, Anna Solieri Morag Burgess-Russell, Celia Lesquerre, Emma McMahon, Josie Macfadyen, Ann Maconachie, and Liz Stapleton for their contributions to the study. We thank Brian Solts, Anna Day, John McMaster, Lynne Harrison for data collection, Beth Tayler and Lucy Brierley for data analysis. Dr. Black has received research support from Forest Laboratories and royalties from American Psychiatric Publishing, Inc. and Oxford University Press. Ms. Blum has received royalties from American Psychiatric Publishing, Inc. and from Blum’s Books. Ms. Harvey has no competing interests.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Harvey, R., Black, D.W. & Blum, N. Systems Training for Emotional Predictability and Problem Solving (STEPPS) in the United Kingdom: A Preliminary Report. J Contemp Psychother 40, 225–232 (2010). https://doi.org/10.1007/s10879-010-9150-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10879-010-9150-4