Borderline personality disorder (BPD) is a potentially severely debilitating psychiatric diagnosis that may affect up to 2% of the general population. Hallmarks of BPD include impulsivity, emotional instability, and poor self-image, and those with BPD have increased risk for self-harm and suicide.

Systems Training for Emotional Predictability and Problem Solving (STEPPS) brings together research findings and information on implementation and best practices for a group treatment program for outpatients with BPD. A five-month long program easily learned and delivered by therapists from a wide range of theoretical orientations, STEPPS combines cognitive behavioral therapy, emotion management and behavioral skills training, and psychoeducation with a systems component that involves professional care providers, family, friends, and significant others of persons with BPD. The book provides a detailed description of the program, reviews the body of evidence supporting its use and implementation, and describes its dissemination worldwide and in different settings. Empirical data show that STEPPS is effective and produces clinically important improvement in mood and behavior, while reducing health care utilization. Unique among programs for BPD, STEPPS has been exhaustively studied in correctional systems (both prisons and community corrections), where it is shown to be as effective as in community settings. This volume will be a valuable guide to those in psychiatry, psychology, social work, nursing, and the counseling professions who treat people with BPD.

Donald W. Black, M.D., is Professor of Psychiatry at the University of Iowa Roy J. and Lucille A. Carver College of Medicine. He serves as Director of Residency Training and Vice Chair for Education in the Department of Psychiatry. Dr. Black is an award-winning teacher and clinician, and a leading authority on personality disorders and impulsive behavior. He is a Distinguished Fellow of the American Psychiatric Association and is President of the American Academy of Clinical Psychiatrists.

Nancee S. Blum, M.S.W., is a psychotherapist and Adjunct Instructor of Psychiatry at the University of Iowa Roy J. and Lucille A. Carver College of Medicine. She is the developer of the STEPPS Treatment Program and its derivative versions (with Norm Bartels, Don St. John, and Bruce Pfohl). She also serves as a consultant and provides consultation and training for the STEPPS program in the Iowa Department of Corrections.

Foreword by John Livesley

Preface

About the Editors

Contributors

Chapter 1 - Overview of STEPPS: History and Implementation
Nancee Blum, Don St. John, Bruce Pfohl, and Donald W. Black

Chapter 2 - Research Evidence Supportive of STEPPS
Donald W. Black, Nancee Blum, and Jeff Allen

Chapter 3 - STEPPS in The Netherlands
Horusta Freije

Chapter 4 - STEPPS in Different Service Settings in the United Kingdom
Renee Harvey

Chapter 5 - STEPPS in Correctional Settings
Nancee Blum and Donald W. Black

Chapter 6 - STEPPS in a Residential Therapeutic Community in Italy
Aldo Lombardo

Chapter 7 - Introducing STEPPS on an Inpatient Unit in Italy
Andrea Fossati, Roberta Alesiani, Silvia Boccalon, Laura Giarolli, Serena Borroni, Antonella Somma

Chapter 8 - STEPPS in Adolescent Populations in The Netherlands
Marieke Schuppert, Paul Emmelkamp, and Maaike Nauta

Chapter 9 - Alternatives to Self-Harm Program (ASH) - A Skills-Based Approach to Complement STEPPS
Diane Clare

Appendix: STEPPS forms and worksheets

Index