Adapting Systems Training for Emotional Predictability and Problem Solving (STEPPS) for older adults with personality disorder: a Dutch Delphi study

Abstract

Objective: Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group therapy in which patients with personality disorder are taught emotion and behaviour regulation skills. Since older adults regulate their emotions differently than younger adults, age-specific aspects are suggested to be taken into account in the treatment. Objectives of this study were to determine expert consensus on the applicability of STEPPS for older adults and determine which adjustments should possibly be implemented for a better fit for older adults with personality disorder. Method: A group meeting involving seven experts, with expertise in psychological therapies with older adults, was held. The Delphi method was applied in order to reach consensus on three main statements regarding the applicability of STEPPS in older adults with personality disorder. Results: Most experts (86%) voted against the statement implying the current STEPPS program is applicable for older adults. All experts voted in favour of the statement that adjustments to the STEPPS program at the content level are required. Consensus (≥66.7%) was reached among the experts that adjustments to the STEPPS program are also required at the process level. Conclusions: STEPPS is considered to be applicable for older adults with emotion regulation problems and personality disorder but needs adaptations to enhance its feasibility and efficacy in later life.