A study into the effectiveness of a single-session relational skills training

Plain English summary of protocol

Background and study aims
Personality pathology is characterised by instability in emotions, identity, and interpersonal relationships. Youth with features of borderline personality disorder (BPD) often experience difficulties with emotion regulation, impulse control, and maintaining stable relationships. These difficulties can substantially interfere with developmental tasks typical for adolescence, such as forming an identity, developing close friendships and romantic relationships, and navigating changing relationships with parents or caregivers. Youth with BPD features are more likely to experience negative life events, interpersonal difficulties, school dropout, and self-destructive behaviors such as self-harm and suicidality. These problems could already be recognized at subthreshold level. Despite the importance of social support as a protective factor in reducing self-destructive behaviors, many youth and their close others find it difficult to openly discuss sensitive topics such as self-harm, suicidality, or risk-taking behaviors, often due to fear of negative reactions or feelings of shame and guilt.
SHARE is a single-session systemic intervention embedded within the GGz Centraal HYPE program and based on the principles of Cognitive Analytic Therapy (CAT). The intervention focuses on helping youth and their close others explore how conversations about sensitive topics have occurred in the past and practise more supportive ways of communicating about these issues. By identifying relational patterns and practising new interactional skills together, the intervention aims to foster more self-disclosure, connectedness, and support between youth and their close others. The present study aims to evaluate the effectiveness of SHARE in helping youth and their close others practise skills for sharing sensitive concerns and improving supportive communication within their relationships.

Who can participate?
Youth aged 12-25 years (inclusive) who are starting treatment at GGz Centraal HYPE (a mental health institution department in the Netherlands for youth with characteristics of personality pathology).

What does the study involve?
Participants are randomly allocated to either the intervention or control condition in the starting phase of their treatment. Both groups complete a set of questionnaires at inclusion and after four weeks (with possible extension to eight weeks, based on practical scheduling). Participants in the intervention condition participate in a SHARE therapy session after inclusion. This session consists of one additional session with the young person and their close other(s) to practise skills for sharing. Participants in the control condition will receive care as usual.
SHARE is a single-session intervention with youth and their close other(s), developed as a semi-structured intervention. The session starts with a short introduction, after which the young person and their close other(s) separate to prepare the session in 15 minutes. The young person prepares with a psychologist, and the close other(s) with a systemic therapist. After 15 minutes, the joint conversation starts, focusing on skills needed for sharing. The session closes with a short recap and writing an important message on a card to take home.

What are the possible benefits and risks of participating?
Participants in both groups will complete questionnaires that are linked to the patient care system, allowing clinicians to use the results in the ongoing treatment. This may support clinical care by providing additional insight into the youth's experiences and progress. Participants in the intervention condition will additionally be invited to attend the SHARE therapy session, where they have the opportunity to practise skills for sharing. Their participation will be reported in their file. The burden associated with completing the questionnaires is minimal and reimbursed by making the results available for clinical care. There are no risks expected with participation in the study, as the youth are carefully embedded in treatment at GGz Centraal, following the quality monitoring of the WGBO. This means that it will be possible to talk further about topics discussed during the SHARE session in their treatment-as-usual.

Where is the study run from?
GGz Centraal (e.g., HYPE, Centre of Expertise on Early Intervention for Borderline Personality Disorder), Amersfoort, The Netherlands

When is the study starting and how long is it expected to run for?
July 2026 to April 2029

Who is funding the study?
Zorgondersteuningsfonds (ZoF; The Netherlands)

Who is the main contact?
Dr Christel Hessels, share@ggzcentraal.nl

Contact information

Study information

Eligibility

Locations

Countries of recruitment

• Netherlands

Study participating centre

Results and Publications

Editorial Notes

03/07/2026: Study's existence confirmed by the Medical Ethical Board Utrecht NedMec.