STEPPS for Borderline Personality Disorder

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Simone Hoermann, Ph.D., is a Psychologist in private practice in New York City. She specializes in providing psychotherapy for Personality Disorders, Anxiety, and Depression ...Read More

The acronym STEPPS stands for Systems Training for Emotional Predictability and Problem Solving. STEPPS was developed by Nancee Blum and is a program that has shown to be helpful when provided in addition to other treatments for Borderline Personality Disorder (BPD), such as individual psychotherapy or medication treatment.

Goal and Format

The program’s goal is to educate people with Borderline Personality Disorder about their diagnosis and to help them acquire skills to deal with different aspects of the disorder. The content is taught to people in a group format that is much like a seminar or workshop. The STEPPS program consists of a 20-week basic skills group program that meets once a week for 2 hours, and an additional program after that, which meets twice a month for about a year. The groups are typically led by two trainers for about 6-10 participants.


Program Foundations

The training begins with some basic information on Borderline Personality disorder. The main idea behind STEPPS is that people with BPD have difficulty regulating their emotions and behaviors, but that they can learn skills to do so. One goal is to de-stigmatize the disorder by helping people understand that BPD stems from a certain biological sensitivity or disposition that meets with certain environmental factors.

Role of the Environment

What makes STEPPS different from many other approaches is that people in the person’s environment, such as family members and friends, are included in the training and are used as “reinforcers” of the skills, in other words, they are used as a resource for the person to support them in learning those skills.

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Skills Training and Monitoring

Clients are asked to keep track and monitor their emotions and the intensity of their emotions, as well as their behaviors, on a daily basis. In addition, every week, clients are asked to fill out a self-report questionnaire to monitor their symptoms of BPD. This helps participants to monitor and measure how they are doing and how effectively they are using their new skills.

Taught Skills

STEPPS participants learn how to identify and challenge automatic ways of interpreting events in their lives – called schemas- that can get in their way. Furthermore, some of the skills that are taught in STEPPS include self-care skills (such as sleep, exercise, or balanced eating), as well as problem-solving, communication, and relationship skills.

Sharing and Support

In addition to learning skills for dealing with intense emotions, anxiety, depression, anger, and the self-destructive impulses that often come along with these overwhelming feelings for people with BPD, the STEPPS participants are encouraged to share appropriate topics from their skills training with close friends and family members, and also with their therapists. 

Further Information

There is some research that shows that when STEPPS is added to treatment for BPD as a supplemental intervention, it can improve treatment outcome. For more information, visit the University of Iowa Hospital and Clinics website.

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