Contrasting outcomes of family connections with varying therapeutic intensity in two Swedish treatment centres

Background: A proportion of individuals with pervasive emotion dysregulation or BPD have other severe co-principal diagnoses. In these cases is not uncommon for functioning to be reduced to the extent that living independently is not possible. These individuals can be referred nationally to a residential DBT treatment centre in South Sweden. Because family members of individuals referred nationally are unable to commute to weekly Family Connections (Familjeband) sessions, the manualized program has been modified to an intensive format offered over two weekends spaced one month apart. Aims: To examine whether a modified intensive form of Familjeband produces meaningful therapeutic change, and to compare change trajectories between the standard and intensively delivered programs.

Methods: Family members of individuals registered at two different DBT treatment centers were invited to participate in the study. Standard Familjeband delivered in the outpatient setting followed the 12-15 week manualized session structure. Intensified Familjeband delivered in the residential setting was conducted over two weekends (sessions 1-7 in one weekend; sessions 8-15 in a second weekend). Measures tested mindfulness, quality of life, caregiver burden, psychological difficulties, family climate and relationship to the individual receiving DBT.

Results: Preliminary analyses were performed to examine family members’ pre-post score changes on caregiver burden, psychological difficulties, mindfulness, quality of life and family functioning moderated by therapeutic intensity of Familjeband delivery.

Conclusion: Preliminary results as well as practicalities of implementation with an emphasis on serving family members of complex and difficult-to-reach individuals are discussed.