Evaluation of a short-term group intervention for parents with borderline personality disorder symptoms: Lifeboat

The therapy intervention is an adaptation and combination of two recognised and evidence-based therapies, dialectical behaviour (DBT) which has been further adapted to provide relevant information about parenting to this parental population (hence mother-infant DBT or MI-DBT) combined with key elements of mentalisation based therapy (MDBT). Referred women will attend 10 weekly 2-hour groups each which will address topics of learning mindfulness, distress tolerance, emotional regulation, parenting and interpersonal relationships. The women will have homework which will be discussed in group each week. Infants are cared for in a nearby creche during these 2 hours, and at the end of that time are brought into the group for reunion with their mother, and an exercise based on either new skills the mother has learned or play activities which promote infant regulation and exploration. Two therapists who are either clinical psychologists, mental health social workers or mental health nurses with perinatal and infant mental health training and experience are present during all therapy time, and the infants have care from trained creche workers. A list is kept of attendance and if women do not attend more than 2 consecutive groups, they will not be able to continue. Women who are on waiting lists for MI-DBT will be progressively offered the option of attending Lifeboat, in the order in which they were placed on the waiting list until 12 places are filled for Lifeboat group. If they do not consent, they will remain on the MI-DBT waiting list but asked to voluntarily consent (ie it will not jeopardise their place on the waiting list) to undertake all research data collection until 12 women have accepted becoming wait-list controls. Women on waiting list who may not have been offered a place for Lifeboat as the group is full will also be contacted if still insufficient numbers for waitlist control ie 12, until numbers are completed. Again, if women do not consent, it will not jeopardise their place on the waitlist. There will be 10 women and their infants enrolled for each group. Homework in some weeks is expected to be a brief task each week such as: - mindfully observe your infant - use one of your DBT skills to calm yourself down when a difficult emotion arises. It would be expected that these activities would take about 10 minutes each time to undertake and record. Other weeks would involve completing homework on one occasion during the week following the group – completing a worksheet that involves identifying components of an emotion, or looking at whether an emotion fits the facts of a situation or not and then deciding whether to use ‘opposite action’ or ‘problem solving’. These activities would take about half an hour to 45 minutes to complete. So the expectation would be that clients would be spending between half and hour and an hour a week completing homework.