Clinical Research Directory

Exploring Equine-Assisted Psychotherapy as an Intervention for Those Who Have Received a Diagnosis of Emotionally Unstable Personality Disorder

The purpose of this research is for the multi-disciplinary team at an inpatient psychiatric hospital to investigate more innovative ways to engage service users in order to promote wellbeing and emotional regulation. In particular, there is a focus on engaging patients who do not routinely engage with the Psychology Team. As such, we are aiming to explore the effectiveness of Equine Assisted Psychotherapy (EAP) with the service users on a specialist Personality Disorder ward. EAP is the deliberate inclusion of an equine (e.g. horse, alpaca) amongst a therapy team to improve patient outcomes. This therapy team includes a mental health professional and certified equine specialist, along with equine(s) and client(s). EAP can offer specific psychotherapeutic treatment goals such as addressing trauma and emotion dysregulation. The presence of an equine removes the need for verbal communication, which allows for non-verbal approaches that support self-development; identifying and discussing the feelings, emotions and behaviours generated through interaction with the horse. The presence of equine also provides a unique opportunity for traumatised individuals to build trust with other sentient beings that value connection, safety, and trust. These specific psychotherapeutic treatment goals are especially relevant for those with a diagnosis of Emotionally Unstable Personality Disorder (EUPD). Service users with EUPD present with complex mental health difficulties, often with problems with emotional regulation, attachment, and self-harm. This research will use a qualitative, single arm design in which all participants (inpatients who have received an Emotionally Unstable personality Disorder diagnosis) engage in a novel psychotherapeutic intervention (6 sessions of Equine-Assisted Psychotherapy). Their experiences of this psychotherapeutic intervention will be explored using semi-structured interviews. Researchers and participants will collaborate in using Thematic Analysis to analyse the content of these interviews.

Empathy Anomalies in Emotionally Unstable (Borderline) Personality Disorder

Emotionally unstable (borderline) personality disorder (BPD) is characterised by changeable and extreme emotions and difficulty maintaining relationships. It is often associated with self-harm. Empathy has two components; cognitive empathy (imagining someone else's thoughts and feelings) and emotional empathy (the reciprocal emotional response). People with BPD score low on cognitive empathy but high on emotional empathy. This suggests that they do not easily understand other peoples' perspectives, but their own emotions are very sensitive. This is important because it could align BPD with other neurodiverse conditions. This study will use a computer-based empathy test and short questionnaires to investigate whether empathy changes during the course of BPD, and if the severity of empathy impairments correlate with severity. The tests are the multifaceted empathy test (MET) and the questionnaire of cognitive and affective empathy (QCAE). The MET requires participants to look at photographs of emotive faces, then choose the most appropriate adjective. It takes 30 minutes to complete. The QCAE asks 31 questions like 'it is hard for me to see why some things upset people'. Participants will be invited to join the study when they are diagnosed with BPD. Severity will be measured with the Borderline Symptom List 23, a disability questionnaire, and the number of self-harming episodes per month, the number of hospital assessments per month and the number of hospital admissions per month. Short NHS questionnaires of anxiety, depression and mood will also be completed, along with short reading test. About 30 participants will be assessed 4 times over 2 years.