Non-Randomized Clinical Trial of a Short-Term Therapy Group for Adults Diagnosed With Borderline Personality Disorder: An Intermediate Step in Care

Objective: The aim of this study was to evaluate the effectiveness of Road Maps, a short-term therapy group program (i.e., 12 weeks) as part of an intermediate step in care for adults with a diagnosis of borderline personality disorder (BPD). Method: A pragmatic non-randomized clinical trial study design was utilized to examine the effectiveness of Road Maps in a publicly funded community mental health care setting. First, we examined whether participation in the short-term group intervention (n = 80) resulted in significantly greater reductions in psychopathology and improved psychosocial functioning compared to waiting for the intervention (n = 41). The waitlist condition was naturalistic (> 28 days) in that there was no specific allocation to conditions and all people on the waitlist had the opportunity to participate in the next available group. Second, we examined whether therapeutic gains were maintained at 6-month follow-up across the entire sample (N = 121). Finally, we analysed the proportion of respondents who demonstrated clinically significant change. Results: Relative to people on the waitlist for the intervention, those who participated in the group demonstrated a significantly greater reduction in the primary outcomes of borderline symptom severity and personality dysfunction (e.g., both self and interpersonal functioning) and secondary outcomes (e.g., emotion regulation, reflective functioning, and psychosocial functioning). Therapeutic gains were maintained at 6-month follow-up. Conclusion: Short-term therapy groups such as Road Maps may be a useful intermediate step in a broader model of stepped care aimed at increasing treatment accessibility in resource-constrained environments.