Evaluation of a grouptraining for adolescents (Emotion Regulation Training) with emotion regulation problems - a randomised controlled clinical trial.

Emotional dysregulation is the main symptom of borderline personality disorder (BPD). BPD is an invalidating disorder with much impact on the patient's functioning. Self-injury and suicide attempts frequently occur. These patients pose an enormous demand on public health care, with frequent interventions and many crises. BPD is rarely diagnosed before the age of 18. Nevertheless, symptoms of BPD are often seen at a younger age and lead to significant distress in the adolescent and his or her family. Treatment at an early stage may prevent the development of a full-blown personality disorder in adulthood as well as the negative consequences related to BPD. Although there are different ways of treating adults with BPD, no effective treatment program for adolescents is available in the Netherlands.
At the outpatient clinic of Accare we developed a course for adolescents that was based on a course for adults (STEPPS, developed by Bartels, Crottie and Blum). Adolescents learn to handle emotional dysregulation. A pilot study has currently been conducted. Thus, the practical feasibility of the course is already tested and the measures are explored. Getting control over your emotions and thoughts and taking responsibility for your own behaviour are the main goals of the Emotion Regulation Training. In the pilot study, the ERT gave a significant improvement in patient’s feelings of having control over their emotions, shown by an increase on a scale measuring the locus of control.
The goal of the study is to evaluate the effectiveness of the course, to obtain information on follow-up, and to give an impuls for implementation of the course in the participating centres for mental health care.
The design is a randomised controlled clinical trial. 128 Adolescents in at least five settings for mental health care will be included and randomised into two conditions, namely 1. 17-week course + standardised (embedded) treatment as usual or 2. treatment as usual only.
Assessments take place before and after the course and at one-year follow-up.
Adolescents aged 14-18 years, who were referred to mental health care centres in the North of the Netherlands, suffering from emotional dysregulation, and their parents or caretakers, will be asked to participate in the study.
ERT consists of 17 weekly group sessions (6-9 participants, 1,75 hours), one psycho-educational session with parents/caretakers and/or partners and two booster sessions, at three and six months after the weekly course. The first aim is to learn how to deal with daily stress and psychological vulnerability. Reducing self-harm or harm to others is an important issue.
After the training there will be a session with the adolescent, his or her parents or caretakers, the therapists of the training and the individual therapist, to offer good continuation in the regular treatment.

Has the Emotion Regulation Training for adolescents a surplus value compared to treatment as usual?

ERT consists of 17 weekly group sessions (6-9 participants, 1,75 hours), one psycho-educational session with parents/caretakers and/or partners and two booster sessions, at three and six months after the weekly course. The first aim is to learn how to deal with daily stress and psychological vulnerability. Reducing self-harm or harm to others is an important issue.
After the training there will be a session with the adolescent, his or her parents or caretakers, the therapists of the training and the individual therapist, to offer good continuation in the regular treatment.