Supporting parents with borderline personality disorder through a parenting group intervention: a randomized controlled trial

Abstract

Background: There is a need for a parenting intervention that specifically addresses the concerns for parents with borderline personality disorder (BPD) due to the challenges that these parents experience and the stigma that surrounds parenting with BPD. Such interventions may also prevent intergenerational transmission of psychopathology and support clinicians to provide care within a personality disorder framework. This study aims to evaluate the effectiveness of a brief parenting group intervention for parents with BPD. Trial design: The design was a parallel randomized controlled trial (RCT) with two arms: the brief parenting intervention group and a treatment as usual (TAU) group. Methods: Participants were parents with a diagnosis of BPD who were parenting at least one child between birth and 5 years old. Participants were randomised to either the brief parenting group intervention (Coming up for AIR (CUFA)) through a public mental health service or to TAU. Participants, clinicians, and researchers were not blind to the allocation. It was hypothesised that the CUFA parenting intervention would reduce self-reported parenting stress (primary outcome) and improve parental mental health (secondary outcome) compared to TAU. Results: Participants (N = 93) were randomly allocated to the parenting intervention (n = 45) and TAU (n = 48). For the analyses of the per protocol sample 25 participants in the CUFA parenting intervention and 21 participants in the TAU condition were included. Multi-level analysis on the intention to treat sample indicated that the CUFA parenting intervention (dpre−post = 1.29) significantly reduced parenting stress compared to TAU (dpre−post = 0.01). This finding was replicated in the per protocol sample. Conclusion: A brief parenting intervention can have a positive effect on reducing parenting stress and improving parental mental health. Offering a parenting intervention needs a supportive and integrated approach to lower barriers for service attendance. Future research may investigate the effect on child wellbeing. It is important and in line with treatment guidelines to offer a parenting intervention to people with BPD. Trial registration: Trial registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), number ACTRN12620001257954.