{
  "abstract": "Background\n\nAlthough borderline personality disorder (BPD) is associated with substantial mortality and morbidity, frontline BPD interventions are difficult to access and have suboptimal efficacy. Therefore, there is a pressing need to develop and test brief, optimized BPD interventions. BPD is associated with disrupted intimate relationships, and recent theoretical models suggest that such disruptions may play a central role in driving BPD pathology. This led to the development of Sage, a protocolized, conjoint psychotherapeutic intervention delivered to people with BPD and their intimate partners to treat BPD and simultaneously improve relationship conflict and intimate partner's mental health. While preliminary research supports the efficacy of Sage, a key next step is identifying whether Sage is more efficacious compared to standard care in improving its targets. This manuscript outlines the study protocol for a single-blind, parallel two-arm randomized controlled trial (RCT) comparing Sage to a supportive psychotherapy that is delivered separately to people with BPD and their intimate partners.Methods\n\nCouples wherein one member has BPD (target N = 152 couples) are actively being recruited. After eligibility and baseline assessments are complete, couples are randomized to Sage or Supportive Individual Psychotherapy. Weekly supervision meetings are held for both conditions by independent supervisors to ensure intervention adherence and prevent drift. Primary (BPD symptoms), secondary (relationship conflict, partner mental health), and exploratory outcomes (e.g. people with BPD's emotion dysregulation, suicidal ideation, suicidal and self-injurious behaviors, relationship satisfaction) are assessed by masked assessors at baseline, mid-intervention, post-intervention, and at a one-, three, and six-month follow-up. Generalized mixed linear models using an intent-to-treat philosophy will be conducted to examine differences between study outcomes across conditions.Discussion\n\nResults will illuminate whether Sage is an efficacious means of treating BPD and expanding intervention outcomes to include relationship conflict and partner mental health in a short timeframe.Trial registration\n\nClinicalTrials.gov (ID NCT06458933, registered on June 12, 2024).",
  "abstract_shown": true,
  "affiliations": [
    "Department of Psychology, York University, 4700 Keele St., Toronto, ON, M3J 1P3, Canada. skyefitz@yorku.ca.",
    "Department of Psychology, York University, 4700 Keele St., Toronto, ON, M3J 1P3, Canada.",
    "Division of Women's Mental Health, McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA.",
    "Department of Psychology, University of Winnipeg, 515 Portage Avenue, Winnipeg, MB, R3B 2E9, Canada.",
    "Department of Psychology, University of Windsor, 401 Sunset Drive, Windsor, ON, N9B 3P4, Canada.",
    "Department of Psychological Science, Kennesaw State University, 1000 Chastain Road, Kennesaw, GA, 30144, USA.",
    "Borderline Personality Disorder Clinic, Centre for Addiction and Mental Health, 1001 Queen St W, Toronto, ON, M6J 1H4, Canada.",
    "Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada.",
    "Department of Psychology Toronto Metropolitan University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada.",
    "The Sashbear Foundation, 25 Hartfield Rd, Toronto, ON, M9A 3C8, Canada."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Skye Fitzpatrick",
      "orcid": "0000-0002-1347-1827"
    },
    {
      "affs": [
        1
      ],
      "name": "Vinushini Arunagiri"
    },
    {
      "affs": [
        2
      ],
      "name": "Jenna M Traynor"
    },
    {
      "affs": [
        3
      ],
      "name": "Beverley K Fredborg"
    },
    {
      "affs": [
        4
      ],
      "name": "Alexander R Daros"
    },
    {
      "affs": [
        5
      ],
      "name": "Alexander O Crenshaw"
    },
    {
      "affs": [
        1
      ],
      "name": "Danielle Fitzpatrick"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Shelley F McMain"
    },
    {
      "affs": [
        8
      ],
      "name": "Candice M Monson"
    },
    {
      "affs": [
        9
      ],
      "name": "Lynn Courey"
    },
    {
      "affs": [
        7
      ],
      "name": "Rachel E Liebman"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9yz79k5rh1mxp.bib",
  "cited_by": 0,
  "doi": "10.1186/s12888-026-08374-6",
  "fulltext_url": "https://europepmc.org/articles/PMC13678913",
  "id": "9yz79k5rh1mxp",
  "issns": [
    "1471-244X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42897533",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC435-571"
    ],
    [
      "openalex",
      "3203|Personality Disorders and Psychopathology"
    ]
  ],
  "openalex": "W7170136634",
  "pdf_url": "https://europepmc.org/articles/PMC13678913?pdf=render",
  "pmcid": "PMC13678913",
  "pmid": "42897533",
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/9yz79k5rh1mxp.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:42Z",
      "native_id": "MED:42897533",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42897533"
    },
    {
      "first_seen": "2026-10-30T13:46:09Z",
      "native_id": "23c6b2d3e62d40d4a40ffbc71c7f0845",
      "source": "doaj",
      "url": "https://doi.org/10.1186/s12888-026-08374-6"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:3203|Personality Disorders and Psychopathology",
      "subfield": "psychiatry"
    }
  ],
  "title": "Protocol for a parallel-group superiority randomized controlled trial comparing Sage- a couple psychotherapy- to supportive individual psychotherapy for borderline personality disorder.",
  "title_text": "Protocol for a parallel-group superiority randomized controlled trial comparing Sage- a couple psychotherapy- to supportive individual psychotherapy for borderline personality disorder.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:46:09Z",
  "url": "https://research.draconitic.com/paper/9yz79k5rh1mxp",
  "venue": "BMC psychiatry",
  "versions": []
}