A pilot study of the efficacy of an adventure therapy programme on borderline personality disorder: A pragmatic controlled clinical trial

Abstract

Adventure therapy (AT) is a therapeutic intervention that has demonstrated effectiveness in different populations, but there are no studies on this therapy in borderline personality disorder (BPD). The objective of this study was to assess the response to AT in comparison with treatment as usual (based on cognitive‐behavioural therapy) in patients with BPD. Regarding the comparison of the differences post‐therapy–pre‐therapy between both groups, some metabolic variables improved more in the AT group, with medium–large effect sizes. Almost all psychometric variables evolved better in the AT group, with negligible effects. AT could be considered in BPD treatment because it results in healthier lifestyle habits and increases functionality and quality of life in patients who are prone to self‐destruction. © 2021 John Wiley & Sons, Ltd.

Short- and Long-Term Outcomes of an Adventure Therapy Programme on Borderline Personality Disorder: A Pragmatic Controlled Clinical Trial

“…This was a long-term extension study of a pragmatic pilot clinical trial that evaluated 20 patients with BPD: 10 in an AT group and 10 in a conventional therapy group, based on cognitive behavioural therapy. The study design, population, and results were published in Mendo et al [ 12 ]. We believe that extending follow-up times is important, as some reviews on personality disorders use longitudinal data and conclude that these disorders are moderately stable but also show marked improvement over time.…”

“…Treating patients with BPD can be challenging [ 1 ]. However, research suggests that psychotherapeutic interventions can be effective for individuals with BPD [ 9 , 10 , 11 , 12 ]. A key goal of treatment is to help patients identify and modify dysfunctional traits, replacing them with healthier behavioural, emotional, and relational patterns [ 9 ].…”

“…Thus, given the personality traits associated with people with BPD, AT may be appropriate to intervene in aspects with which people diagnosed with BPD experience difficulties [ 12 , 26 ]. AT confronts the person diagnosed with BPD with their difficulties in an experiential manner, which leads to an increase in their discomfort and the emergence of dysfunctional patterns and escape behaviours (experiential avoidance as dysfunctional automatism) [ 28 , 29 ].…”

“…On this theoretical basis, a pilot study of AT for BPD patients called “Afrontant el Buit” (Facing the Void) was launched and showed promising short-term results (healthier lifestyle habits, greater functionality, and better quality of life) [ 12 ]. This article [ 12 ] describes a pragmatic, controlled, non-randomized clinical trial. The study included patients with a diagnosis of BPD in an Adventure Therapy group and a cognitive behavioural therapy control group.…”

“…The study evaluated clinical, psychosocial, and functional outcomes; quality of life; and physical health levels at two time points: pre- and post-treatment assessments in both the TA and TAU groups and assessments 2–3 years after the end of treatment. Based on the reviewed studies and considering the promising short-term results obtained in the pilot study [ 12 ], this study proposes two hypotheses: (1) completion of the AT intervention will result in improvement in the mentioned areas compared to the group performing the CBT intervention, and (2) patients who undergo the AT intervention will achieve better results than those who undergo the CBT intervention in the long term (2–3 years).…”