This study aims to explore the feasibility, acceptability, and effectiveness of a new
blended psychotherapeutic treatment program based on Dynamic Interpersonal Therapy
(B-DIT) for adult clients with personality pathology. B-DIT integrates face-to-face (FTF)
therapy and online modules into a cohesive treatment program, offering potential
advantages in terms of treatment accessibility and cost-effectiveness for individuals
with personality pathology. Additionally, blended interventions may have added value
compared to traditional FTF approaches by fostering a greater sense of agency and
ownership among clients regarding their treatment. While e-health and blended
interventions have demonstrated promising treatment outcomes across various mental health
areas, there is limited evidence for interventions targeting personality pathology.
B-DIT, developed collaboratively by Dutch mental health care institute De Viersprong and
OnlinePsyHulp, addresses this gap and provides a blended intervention for clients with
mild to moderately severe personality pathology. The program spans three phases: an
individual phase lasting approximately two months, followed by a four-month group phase,
and concluding with a four-month booster phase to reinforce positive changes.
Face-to-face therapy sessions and online treatment modules are utilized alternately and
complementarily throughout all treatment phases.
The primary study aims are (1) to monitor and evaluate the feasibility of B-DIT; which
includes evaluating client satisfaction, treatment drop-out rates, user parameters
related to online modules, and conducting a qualitative analysis of therapists' and
clients' experiences; and (2) to gather initial effectiveness data based on Routine
Outcome Monitoring (ROM) measurements, complemented by a Single Case Experimental Design
(SCED). The SCED allows drawing conclusions about effectiveness based on a relatively
small sample, while accommodating potential refinements to the intervention during the
study period. The following research questions will be addressed:
How acceptable is a blended treatment program, Dynamic Interpersonal Therapy
(B-DIT), for adult clients with personality pathology and for their therapists?
How effective is B-DIT for adult clients with personality pathology in terms of
progress in improving symptom burden, overall functioning, and personality
functioning, along with changes in process measures (mentalizing ability, epistemic
trust, agency)?
Exploratively, the effects on these process and outcome measures across treatment
phases will be compared to determine if observed changes are consistent with the
presumed working mechanisms of the intervention.
Participants in the study will receive care as usual. In complement to regular Routine
Outcome Monitoring assessments as integrated part of treatment, participants will be
asked to complete an additional 26-item questionnaire repeatedly during their treatment
and over a one year follow-up period in a Single Case Experimental Design with four
phases:
Phase A - Baseline Waiting List (before start of treatment) - with a minimum of 3 weeks;
Phase B - Intensive treatment phase (10 weeks of individual treatment followed by 30
weeks of group treatment) - 30 weeks; Phase C - Booster treatment phase - 16 weeks; Phase
D - Follow-up phase after the end of treatment - 12 months.
The (impact of) expectations with regards to their treatment will be assessed at baseline
and at end of treatment. Clients and clinicians will be questioned about their
experiences in the treatment program (at the end of treatment) by means of
semi-structured qualitative interviews.