A randomized controlled trial of a peer and clinician led group program for borderline personality disorder

<b>Objective:</b> Remission and recovery from borderline personality disorder (BPD) is difficult, yet achievable, yet not all people benefit. Peers with lived experience of recovery from BPD as co-therapists may increase engagement, reduce stigma and strengthen hopefulness. We evaluated a peer and clinician co-led group therapy (AIR Peers) for consumers with BPD.<b>Methods:</b> Eighty-three participants (88% female, <i>M</i> age = 36yrs) were randomized into either AIR Peers therapy (<i>n</i> = 43) or treatment as usual (TAU; <i>n</i> = 40). The intervention was co-designed by people with lived experience and clinicians. It involved 12 hours of group therapy over a 6-week period (2hrs/week). Weekly topics included discussion of stigma, self-compassion, self-care, creative recovery and "building your best life."<b>Results:</b> Intention to treat multilevel modeling analysis indicated that the AIR Peers group showed a significant reduction in BPD symptoms (primary outcome) and improvement in mental health ratings (secondary outcome), whereas no change was present in the TAU group. Self-report ratings indicated therapy success, helpfulness, and satisfaction. Quantitative and qualitative ratings of group and therapist alliance and group engagement were positive.<b>Conclusion:</b> Peer and clinician co-facilitated therapy groups may contribute to novel and effective approaches for people living with BPD on their recovery journey.<b>Trial registration</b>Australian New Zealand Clinical Trials Registry identifier: ACTRN12621000183886.