Grant: Project Grant

Borderline Personality Disorder (BPD) is a complex and chronic mental health condition affecting 1-2% of Canadians. The best treatment for BPD is intensive psychotherapy. Specialized psychotherapies for BPD, however, are long (12+ months), expensive, and difficult to access. As a result, many people with BPD never get the treatment they need and instead rely on crisis-based psychiatric emergency and inpatient services for support. Improving access to evidence-based treatments for BPD would reduce healthcare costs and help more people recover. One of the major factors limiting access to specialized BPD therapies is the reliance on specialized, Master's- or Doctoral-level clinicians to deliver such treatments. Recent evidence shows that structured psychosocial interventions can be effectively delivered by peer workers, and that adapting programs to this format offers unique benefits not found in clinician-led services. Our project builds on this evidence to address the urgent service need-access gap for people with BPD. Specifically, we will adapt Dialectical Behavior Therapy (DBT) Skills Training, a structured 24-week group program that teaches skills for managing emotions and relationships, for peer-to-peer delivery (DBT-P2P). We aim to create a well-defined program that community mental health settings can readily implement to augment existing BPD services and increase access to high-quality care. Our implementation focus led us to two approaches: 1. We use co-design principles to develop the DBT-P2P program, using interviews and consensus-building with intended consumers, peer facilitators, organization leaders, and expert clinicians to understand their needs. 2. We use practice-based research to test the acceptability, feasibility and safety of the program in a community non-profit that is representative of the intended program users. Doing so will maximize the potential scalability of DBT-P2P, ultimately helping more people get the support they need.