Internal Family Systems Therapy for Borderline Personality Disorder

Condition(s) studied

Investigational drug(s) / intervention(s)

Internal family systems therapy: The internal family systems model was developed by Richard C. Schwartz in the 1980s. This psychotherapy is based on the assumption that the human mind is naturally multiple and consists of interacting sub-personalities ("parts"), including protective and vulnerable parts, shaped by development and adversity. All parts are assumed to have positive intentions, even when their effects are maladaptive; therapy therefore aims to transform rather than eliminate them. Internal family systems therapy further posits the existence of a core Self in every person, characterized by qualities such as compassion, clarity, and calm, which is inherently intact in each individual and capable of leading the internal system. Therapeutic change involves increasing the leadership skills of the core Self, building trusting relationships among parts and the core Self, and unburdening vulnerable parts so they can assume more adaptive roles, supporting improved emotion regulation and well-being.

Study summary

Borderline Personality Disorder (BPD) involves intense emotional ups and downs, unstable relationships, impulsivity, and a poor sense of self. These challenges often lead to addiction, self-harm, and frequent use of healthcare services. While certain treatments already in practice - such as dialectical behavior therapy - can help, they don't work for everyone or address all aspects of the disorder. This study plans to explore internal family systems (IFS) therapy, a method that views the mind as made up of different "parts" - each with its own thoughts and feelings. IFS helps people build understanding and compassion toward these parts and connect with a calmer, more centered "Self." This may be especially useful for those with BPD, who often feel fragmented and extremely critical of themselves and others. This will be the first study to examine internal family systems therapy for BPD. The participants (15 in total) will receive up to 50 individual sessions over 15 months. Changes in symptoms and overall mental health will be measured at four points during the study. People with lived experience of BPD will help shape the research to ensure it is relevant, respectful, and useful for others facing similar challenges.

Eligibility

Primary outcome measure(s)

• Severity of borderline personality disorder symptomatology - disorder-specific mental distress — Change in scores between baseline and intervention end (approx. 12-15 months)
  This first indicator of the primary outcome will be assessed by the Borderline Symptom List (BSL-23, Bohus et al., 2009). This self-report measure consists of items that 1) are based on DSM diagnostic criteria as well as expert opinions and expert-by-experience input; and 2) displayed a high level of sensitivity to change and ability to discriminate individuals with versus without borderline personality disorder. Scale items cover areas such as affective instability, emotional pain, identity disturbance, interpersonal sensitivity, cognitive-perceptual distress, impulsivity-related subjective distress, and suicidal ideation. Total scores range from 0 to 92 with higher scores indicating greater severity of borderline personality disorder symptoms.
• Severity of borderline personality disorder symptomatology - dysfunctional behaviors — Change in scores between baseline and intervention end (approx. 12-15 months)
  This second indicator of the primary outcome will be assessed by the supplementary scale of the Borderline Symptom List (BSL). This 11-item scale (BSL-Supplement; Bohus et al., 2007) assesses the extent of dysfunctional behaviours associated with borderline personality disorder such as self-injurious behaviour, suicidality, binge and purge behaviours, impulsivity, hostile outbursts, and sexual promiscuity. Total scores range from 0 to 44 with higher scores reflecting greater frequency or severity of borderline-related behaviors.

Trial sites (1)

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