Efficacy of Emotion Efficacy Therapy on Emotional Reactivity and Self-Harming Behaviors in Individuals with Borderline Personality Disorder
Keywords:
The effectiveness of emotion, focused therapy on emotional reactivity and self, harming behaviors in individuals with borderline personality disorderAbstract
Introduction and Aim: Borderline personality disorder is characterized by emotional instability, heightened emotional reactivity, and self-harming behaviors, with emotion dysregulation representing a major mechanism underlying the persistence of these difficulties. This study aimed to determine the efficacy of Emotion Efficacy Therapy in reducing emotional reactivity and self-harming behaviors among individuals with borderline personality disorder.
Methodology: This study employed a single-case experimental design with asynchronous multiple baselines and continuous assessment. Four patients with borderline personality disorder referred to psychological centers in Tabriz, Iran, in 2026 were selected through purposive sampling according to predefined inclusion and exclusion criteria. Data were collected using the Structured Clinical Interview, Millon Clinical Multiaxial Inventory, Emotion Reactivity Scale, and Self-Harm Inventory. Following baseline assessments, participants entered the intervention sequentially and received eight individual sessions of Emotion Efficacy Therapy. Follow-up assessments were conducted one and two months after treatment. Data were analyzed using visual analysis, the Reliable Change Index (RCI), improvement rate, clinically significant change, and indices of trend and stability.
Findings: Emotion Efficacy Therapy produced clinically significant reductions in self-harming behaviors across all participants. RCI values ranged from 4.94 to 6.44 at post-treatment and from 5.26 to 6.54 at follow-up, while follow-up improvement rates ranged from 57% to 69%. Emotional reactivity also decreased significantly in all participants, with post-treatment RCI values ranging from 4.09 to 6.37 and follow-up values ranging from 4.12 to 6.40; follow-up improvement rates ranged from 53% to 69%. For both outcomes, all RCI values exceeded the 1.96 criterion for reliable change, and the therapeutic gains were maintained through the second follow-up assessment.
Conclusion: Emotion Efficacy Therapy appears effective in reducing emotional reactivity and self-harming behaviors in individuals with borderline personality disorder by strengthening emotional acceptance, distress tolerance, meta-awareness, emotion regulation, and value-consistent responding. The maintenance of improvements during follow-up supports the potential utility of this approach as a complementary intervention for managing emotional and behavioral difficulties associated with borderline personality disorder.
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Copyright (c) 2025 Majid Mahmoud Alilou; Touraj Hashemi, Mansour Bayrami, Naimeh Mashinchi Abbasi, Amir Masoud Nejati (Author)
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