Sage: A Couple Intervention for Borderline Personality Disorder

Sage is a 12-session manualized weekly intervention delivered to people with borderline personality disorder (BPD) and their intimate partners. The Sage intervention consists of three phases: Phase 1, orientation and safety which focuses on targeting destructive behaviours (e.g., suicide attempts and self harm engagement) by providing couples with safety strategies that target suicide risk/ crisis, education about BPD, the role of emotion dysregulation and intimate relationship dysfunction in maintaining it (\~three sessions). Next, Phase 2, communication and emotion skills entails couples learning communication skills and strategies for identifying, expressing, and regulating emotions (\~five sessions). Lastly, in Phase 3, cognitive skills and intervention termination, couples learn strategies to target negative cognitions that elicit emotion dysregulation and intimate relationship dysfunction (\~four sessions).

Supportive Individual Psychotherapy (SIP) is a comparator in our control condition reflects enhanced usual care (i.e., case management/supportive psychotherapy) for people with BPD. Both people with BPD and partners will receive SIP sessions separately over the course of 12 sessions, delivered by therapists. For both members of the couple, SIP will involve 12 sessions of a specific form of supportive psychotherapy (referred to in other trials as case management; Linehan et al., 2015) that has been successfully used as a standard care control for individual therapy contact in BPD treatment RCTs (Linehan et al., 2015). This intervention involves conducting a needs assessment, providing resources/information (e.g., referrals), offering assistance with problems in living (e.g., eviction), and providing supportive, empathic responses.