Wilson Jon, Gee Brioney, Martin Nicola, Maxwell Sarah, Murdoch Jamie, Clarke Tim, Clark Allan, Turner David, Katangwe-Chigamba Thando, Jones Peter B, Fonagy Peter
Norfolk and Suffolk NHS Foundation Trust, Hellesdon Hospital, Drayton High Road, Norwich, UK.
Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK.
Pilot Feasibility Stud. 2025 Jul 19;11(1):102. doi: 10.1186/s40814-025-01679-5.
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).
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.
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.
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.
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.
ISRCTN16862589.
迫切需要可及的干预措施，以促进对有边缘型人格障碍（BPD）症状的年轻人进行早期干预。现有的针对青少年BPD的循证干预措施资源消耗极大，很少有有BPD症状的年轻人能获得及时治疗。我们对先前在二级心理健康服务中提供的针对青少年BPD症状的简短心理治疗进行了调整，以便在学校和学院中实施。本研究旨在评估在未来的随机对照试验（RCT）中评估这种干预措施（BEST（简短教育支持治疗））的有效性和成本效益的可行性。
可行性随机对照试验涉及12所学校和学院。符合条件的参与者年龄在13至18岁之间，自我报告的BPD症状高于临床阈值且有反复自我伤害史。在9个月的时间里，32名参与者被随机分配接受BEST干预加常规治疗（TAU）或仅接受TAU。在基线、12周和24周时对参与者进行评估。进行了混合方法的过程评估。
招募速度比预期慢，但参与者保留率很高（12周时为89.5%，24周时为73.7%）。所有结局指标的表现都令人满意。干预实施的保真度很高（依从率为93.5%），我们没有发现任何对照组受到污染的证据。工作人员和年轻人认为该干预措施对参与者、从业者以及更广泛的学校/学院有益，因此非常可接受。
该研究因学校和学院因应对COVID-19大流行而关闭而中断。这减少了参与者招募的时间窗口并限制了数据收集。
该干预措施在学校和学院中成功实施，工作人员和年轻人都可以接受。研究结果为继续开展该研究项目提供了支持，并应为未来干预结果评估的设计提供参考。
ISRCTN16862589。
