Feasibility randomised controlled trial of a brief psychological intervention for adolescents with borderline personality disorder symptoms delivered with schools and colleges.
Jon Wilson, Brioney Gee, Nicola Martin, Sarah Maxwell, Jamie Murdoch, Tim Clarke, Allan Clark, David Turner, Thando Katangwe-Chigamba, Peter B Jones, Peter Fonagy
{"title":"Feasibility randomised controlled trial of a brief psychological intervention for adolescents with borderline personality disorder symptoms delivered with schools and colleges.","authors":"Jon Wilson, Brioney Gee, Nicola Martin, Sarah Maxwell, Jamie Murdoch, Tim Clarke, Allan Clark, David Turner, Thando Katangwe-Chigamba, Peter B Jones, Peter Fonagy","doi":"10.1186/s40814-025-01679-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There is an urgent need for accessible interventions to facilitate early intervention for young people with borderline personality disorder (BPD) symptoms. Existing evidence-based interventions for adolescent BPD are highly resource-intensive, and few young people with BPD symptoms have access to timely treatment. We adapted a brief psychological treatment for adolescent BPD symptoms previously provided within secondary mental health services for delivery within schools and colleges. This study aimed to assess the feasibility of evaluating the effectiveness and cost-effectiveness of this intervention (BEST (brief education support treatment)) in a future randomised controlled trial (RCT).</p><p><strong>Methods: </strong>The feasibility RCT involved 12 schools and colleges. Eligible participants were aged 13-18 years and self-reported BPD symptoms above a clinical threshold and a history of repeated self-harm. Over 9 months, 32 participants were randomised to receive either the BEST intervention plus treatment as usual (TAU) or TAU alone. Participants were assessed at baseline and 12 and 24 weeks. A mixed-methods process evaluation was conducted.</p><p><strong>Results: </strong>Recruitment was slower than anticipated, but participant retention was high (89.5% at 12 weeks and 73.7% at 24 weeks). Performance of all outcome measures was satisfactory. Fidelity of intervention delivery was high (93.5% adherent), and we did not identify any evidence of contamination of the control arm. The intervention was perceived by staff and young people as beneficial to participants, practitioners and the wider school/college and therefore highly acceptable.</p><p><strong>Limitations: </strong>The study was disrupted by the closure of schools and colleges in response to the COVID-19 pandemic. This reduced the window for participant recruitment and limited data collection.</p><p><strong>Conclusions: </strong>The intervention was delivered successfully within schools and colleges and was acceptable to staff and young people. The findings provide support for continuing this programme of research and should inform the design of a future evaluation of intervention outcomes.</p><p><strong>Trial registration number: </strong>ISRCTN16862589.</p>","PeriodicalId":20176,"journal":{"name":"Pilot and Feasibility Studies","volume":"11 1","pages":"102"},"PeriodicalIF":1.6000,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275424/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pilot and Feasibility Studies","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s40814-025-01679-5","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: There is an urgent need for accessible interventions to facilitate early intervention for young people with borderline personality disorder (BPD) symptoms. Existing evidence-based interventions for adolescent BPD are highly resource-intensive, and few young people with BPD symptoms have access to timely treatment. We adapted a brief psychological treatment for adolescent BPD symptoms previously provided within secondary mental health services for delivery within schools and colleges. This study aimed to assess the feasibility of evaluating the effectiveness and cost-effectiveness of this intervention (BEST (brief education support treatment)) in a future randomised controlled trial (RCT).
Methods: The feasibility RCT involved 12 schools and colleges. Eligible participants were aged 13-18 years and self-reported BPD symptoms above a clinical threshold and a history of repeated self-harm. Over 9 months, 32 participants were randomised to receive either the BEST intervention plus treatment as usual (TAU) or TAU alone. Participants were assessed at baseline and 12 and 24 weeks. A mixed-methods process evaluation was conducted.
Results: Recruitment was slower than anticipated, but participant retention was high (89.5% at 12 weeks and 73.7% at 24 weeks). Performance of all outcome measures was satisfactory. Fidelity of intervention delivery was high (93.5% adherent), and we did not identify any evidence of contamination of the control arm. The intervention was perceived by staff and young people as beneficial to participants, practitioners and the wider school/college and therefore highly acceptable.
Limitations: The study was disrupted by the closure of schools and colleges in response to the COVID-19 pandemic. This reduced the window for participant recruitment and limited data collection.
Conclusions: The intervention was delivered successfully within schools and colleges and was acceptable to staff and young people. The findings provide support for continuing this programme of research and should inform the design of a future evaluation of intervention outcomes.
期刊介绍：
Pilot and Feasibility Studies encompasses all aspects of the design, conduct and reporting of pilot and feasibility studies in biomedicine. The journal publishes research articles that are intended to directly influence future clinical trials or large scale observational studies, as well as protocols, commentaries and methodology articles. The journal also ensures that the results of all well-conducted, peer-reviewed, pilot and feasibility studies are published, regardless of outcome or significance of findings. Pilot and feasibility studies are increasingly conducted prior to a full randomized controlled trial. However, these studies often lack clear objectives, many remain unpublished, and there is confusion over the meanings of the words “pilot” and “feasibility”. Pilot and Feasibility Studies provides a forum for discussion around this key aspect of the scientific process, and seeks to ensure that these studies are published, so as to complete the publication thread for clinical research.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
