Systems Training for Emotional Predictability and Problem Solving for Borderline Personality Disorder

Implementing STEPPS Around the Globe

Edited by Donald W. Black and Nancee Blum

Empirically proven, effective treatment for people with Borderline Personality Disorder
Involves the client's "system," which includes family members and friends
Listed in the US Substance Abuse and Mental Health Services Administration (SAMSHA) National Registry of Evidence-based Practices
More easily taught and delivered and more economical than other programs developed for people with BPD
Well accepted by patients and mental health professionals
Routinely used in correctional systems and community settings
Includes an Appendix with STEPPS forms and worksheets

Systems Training for Emotional Predictability and Problem Solving for Borderline Personality Disorder

Implementing STEPPS Around the Globe

Edited by Donald W. Black and Nancee Blum

Description

Borderline personality disorder (BPD) is a potentially severely debilitating psychiatric diagnosis that may affect up to 2% of the general population. Hallmarks of BPD include impulsivity, emotional instability, and poor self-image, and those with BPD have increased risk for self-harm and suicide.

Systems Training for Emotional Predictability and Problem Solving (STEPPS) brings together research findings and information on implementation and best practices for a group treatment program for outpatients with BPD. A five-month long program easily learned and delivered by therapists from a wide range of theoretical orientations, STEPPS combines cognitive behavioral therapy, emotion management and behavioral skills training, and psychoeducation with a systems component that involves professional care providers, family, friends, and significant others of persons with BPD. The book provides a detailed description of the program, reviews the body of evidence supporting its use and implementation, and describes its dissemination worldwide and in different settings. Empirical data show that STEPPS is effective and produces clinically important improvement in mood and behavior, while reducing health care utilization. Unique among programs for BPD, STEPPS has been exhaustively studied in correctional systems (both prisons and community corrections), where it is shown to be as effective as in community settings. This volume will be a valuable guide to those in psychiatry, psychology, social work, nursing, and the counseling professions who treat people with BPD.

Systems Training for Emotional Predictability and Problem Solving for Borderline Personality Disorder

Implementing STEPPS Around the Globe

Edited by Donald W. Black and Nancee Blum

Foreword by John Livesley

Preface

About the Editors

Contributors

Chapter 1 - Overview of STEPPS: History and Implementation
Nancee Blum, Don St. John, Bruce Pfohl, and Donald W. Black

Chapter 2 - Research Evidence Supportive of STEPPS
Donald W. Black, Nancee Blum, and Jeff Allen

Chapter 3 - STEPPS in The Netherlands
Horusta Freije

Chapter 4 - STEPPS in Different Service Settings in the United Kingdom
Renee Harvey

Chapter 5 - STEPPS in Correctional Settings
Nancee Blum and Donald W. Black

Chapter 6 - STEPPS in a Residential Therapeutic Community in Italy
Aldo Lombardo

Chapter 7 - Introducing STEPPS on an Inpatient Unit in Italy
Andrea Fossati, Roberta Alesiani, Silvia Boccalon, Laura Giarolli, Serena Borroni, Antonella Somma

Chapter 8 - STEPPS in Adolescent Populations in The Netherlands
Marieke Schuppert, Paul Emmelkamp, and Maaike Nauta

Chapter 9 - Alternatives to Self-Harm Program (ASH) - A Skills-Based Approach to Complement STEPPS
Diane Clare

Appendix: STEPPS forms and worksheets

Index

Systems Training for Emotional Predictability and Problem Solving for Borderline Personality Disorder

Implementing STEPPS Around the Globe

Edited by Donald W. Black and Nancee Blum

Author Information

Donald W. Black, M.D., is Professor of Psychiatry at the University of Iowa Roy J. and Lucille A. Carver College of Medicine. He serves as Director of Residency Training and Vice Chair for Education in the Department of Psychiatry. Dr. Black is an award-winning teacher and clinician, and a leading authority on personality disorders and impulsive behavior. He is a Distinguished Fellow of the American Psychiatric Association and is President of the American Academy of Clinical Psychiatrists.

Nancee S. Blum, M.S.W., is a psychotherapist and Adjunct Instructor of Psychiatry at the University of Iowa Roy J. and Lucille A. Carver College of Medicine. She is the developer of the STEPPS Treatment Program and its derivative versions (with Norm Bartels, Don St. John, and Bruce Pfohl). She also serves as a consultant and provides consultation and training for the STEPPS program in the Iowa Department of Corrections.

Contributors:

Roberta Alesiani
San Raffaele Hospital, Milano, Italy

Jeff Allen, PhD
Department of Psychiatry
University of Iowa Roy J. and Lucille A. Carver College of Medicine
Iowa City, IA, USA

Donald W. Black, MD
Department of Psychiatry
University of Iowa Roy J. and Lucille A. Carver College of Medicine
Iowa City, IA, USA

Nancee Blum, MSW
Department of Psychiatry
University of Iowa Roy J. and Lucille A. Carver College of Medicine
Iowa City, IA, USA

Silvia Boccalon
San Raffaele Hospital, Milano, Italy

Serena Borroni
San Raffaele Hospital, Milano, Italy
Vita-Salute San Raffaele University, Milano, Italy

Diane Clare, Dip Clin Psych, AFBPsS
Mind Business Consultancy, Nelson, New Zealand

Paul Emmelkamp, PhD
Netherlands Institute for Advanced Study
Wassenaar, the Netherlands
The Center for Social and Humanities Research
King Abdu lAziz University
Jeddah, Saudi Arabia

Andrea Fossati, MD, PhD,
LUMSA University, Rome, Italy
San Raffaele Hospital, Milano, Italy

Horusta Freije, MD
Association of Cognitive and Behavioral Therapy
Dutch Psychotherapy Association
The Netherlands

Laura Giarolli
San Raffaele Hospital, Milano, Italy

Renee Harvey, MA
Sussex Partnership
National Health Service Foundation Trust
United Kingdom

Aldo Lombardo, MD
Raymond Gledhill Residential Centre of Integrated Sociotherapy
Rome, Italy

Maaike Nauta, PhD
Department of Psychiatry
University Medical Center
Department of Clinical Psychology
University of Groningen
Groningen, The Netherlands

Bruce Pfohl, MD
Department of Psychiatry
University of Iowa Roy J. and Lucille A. Carver College of Medicine
Iowa City, IA, USA

Marieke Schuppert, MD, PhD
Department of Psychiatry
University of Groningen
Groningen, The Netherlands

Antonella Somma
LUMSA University, Rome, Italy

Don St. John, PA
Department of Psychiatry
University of Iowa Roy J. and Lucille A. Carver College of Medicine
Iowa City, IA, USA

Systems Training for Emotional Predictability and Problem Solving for Borderline Personality Disorder

Implementing STEPPS Around the Globe

Edited by Donald W. Black and Nancee Blum

Reviews and Awards

"Psychotherapy for borderline personality disorder is now known to be effective. But it tends to be lengthy, expensive, and unavailable. STEPPS provides a brief, cost-effective package that should be a default option for treating these difficult patients. This book, which describes the concepts, methods, and research support behind STEPPS, is timely and welcome."--Joel Paris, MD, Professor of Psychiatry, McGill University, and author, A Concise Guide to Personality Disorders

"This book brings together the leading clinicians and researchers working with STEPPS across the globe and provides an essential guide to implementing a much needed front-line intervention for borderline personality disorder."--Carla Sharp, PhD, Professor and Director of Clinical Training, Department of Psychology, The University of Houston

"Dr. Black and Ms. Blum have edited a very thoughtful and informative book on the STEPPS program for people with borderline personality disorder. STEPPS is a very well designed and structured treatment, which could help explain why it has been rapidly expanding in its global reach. This book reviews the compelling evidence base for the program and makes an important contribution to the care of these challenging patients."--S. Charles Schulz, MD, Professor, Department of Psychiatry, University of Minnesota Medical School

"The development of STEPPS has been a godsend. Even in the age of evidence-based treatments for borderline personality disorder, the large majority of sufferers have no access to adequate care. With its intelligent focus on psychoeducation in a group setting, STEPPS has been able to fill in the gap in many areas. This book will extend that reach. STEPPS fulfills the critical public need of providing a basic treatment for BPD that is sufficient for some patients and the first step in a longer trajectory for others."--Frank E. Yeomans, MD, PhD, Clinical Associate Professor of Psychiatry, and Director of Training, Personality Disorders Institute, Weill Medical College of Cornell University

"In treating borderline personality disorder in community mental health settings, it is vital that evidence-based protocols for treating suicidal behavior be utilized. For treatment settings unable to implement DBT, strong consideration should be given to implementing STEPPS. For this reason, this book is recommended for those who work for or administer community mental health centers, as well mental health programs in other settings, such as correctional settings or group practices." --PsycCRITIQUES