The development and testing of joint crisis plans for people with borderline personality disorder: a feasibility study
type: CreativeWork
description: Background: This dissertation focuses on effective crisis management for people with borderline personality disorder. The dissertation reports a single-blind randomised controlled trial investigating the effectiveness of joint crisis plans (JCPs; a type of advance statement regarding future treatment preferences for people with mental health problems) compared with treatment as usual for community-dwelling adults meeting research diagnostic criteria for borderline personality disorder. Methods: During the developmental phase, three focus groups were held with mental health service users, clinicians and academics in order to adapt an existing joint crisis plan template, the utility of which was then tested in a small (N=13) pilot study. Participants in the resulting larger trial were recruited from community mental health teams in south London and randomised to receive either treatment as usual (TAU) or a joint crisis plan plus treatment as usual. Participants were assessed on a number of variables prior to randomisation and again at six-month follow-up and these included self-harm, engagement with services, therapeutic alliance and health-related quality of life. Results: Eighty-eight adults out of the 133 referred were eligible and consented before being randomised to receive a joint crisis plan in addition to treatment as usual (n = 46) or TAU alone (n = 42). This represented approximately 75% of the target sample size. Follow-up data were collected on 73 (83.0%) participants. A modified intention-to-treat analysis revealed no significant differences in the 6 proportion of participants who reported self-harming (odds ratio (OR) = 1.9, 95% CI: 0.53–6.5, P=0.33) or the frequency of self-harming behaviour (rate ratio (RR) = 0.74, 95% CI: 0.34–1.63, P=0.46) between the two groups at follow-up. No significant differences were observed between the two groups on any of the secondary outcome measures. JCPs were viewed favourably by participants, who reported referring to …
abstract: Background: This dissertation focuses on effective crisis management for people with borderline personality disorder. The dissertation reports a single-blind randomised controlled trial investigating the effectiveness of joint crisis plans (JCPs; a type of advance statement regarding future treatment preferences for people with mental health problems) compared with treatment as usual for community-dwelling adults meeting research diagnostic criteria for borderline personality disorder. Methods: During the developmental phase, three focus groups were held with mental health service users, clinicians and academics in order to adapt an existing joint crisis plan template, the utility of which was then tested in a small (N=13) pilot study. Participants in the resulting larger trial were recruited from community mental health teams in south London and randomised to receive either treatment as usual (TAU) or a joint crisis plan plus treatment as usual. Participants were assessed on a number of variables prior to randomisation and again at six-month follow-up and these included self-harm, engagement with services, therapeutic alliance and health-related quality of life. Results: Eighty-eight adults out of the 133 referred were eligible and consented before being randomised to receive a joint crisis plan in addition to treatment as usual (n = 46) or TAU alone (n = 42). This represented approximately 75% of the target sample size. Follow-up data were collected on 73 (83.0%) participants. A modified intention-to-treat analysis revealed no significant differences in the 6 proportion of participants who reported self-harming (odds ratio (OR) = 1.9, 95% CI: 0.53–6.5, P=0.33) or the frequency of self-harming behaviour (rate ratio (RR) = 0.74, 95% CI: 0.34–1.63, P=0.46) between the two groups at follow-up. No significant differences were observed between the two groups on any of the secondary outcome measures. JCPs were viewed favourably by participants, who reported referring to …
author: Borschmann, Rohan
language: eng
date published: 2014-5-1
date modified: 2026-07-24T02:44:34Z
provider: King's College London
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: King's College London