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Simone Hoermann, Ph.D.Simone Hoermann, Ph.D.
A blog about the personality disorders (borderline, narcissistic, etc.) with a focus on research and therapy

STEPPS for Borderline Personality Disorder

Simone Hoermann, Ph.D. Updated: Oct 25th 2009

feet walking in sand leaving footprintsThe 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, such as individual psychotherapy or medication treatment.


            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 lead by two trainers for about 6-10 participants.

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

            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 Borderline Personality Disorder.  This helps participant to monitor and measure how they are doing and how effectively they are using their new 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.

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 Borderline Personality Disorder, the STEPPS participants are encouraged to share appropriate topics from their skills training with close friends and family members, and also with their therapists.  This sharing of information can be helpful for family members to gain a better understanding of what the person is going through, and how to respond in emotionally charged situations.  Furthermore, sharing the information can help the participant and the family to develop a shared language and terminology for what is going on and what skills to use. 

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

Simone Hoermann, Ph.D.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. She is a faculty member of Columbia University, and facilitates psychotherapy and skills training groups at the Columbia East 60th Street Day Treatment Program.

Reader Comments
Discuss this issue below or in our forums.

I was asked to leave the STEPPS programme for disagreeing about self harm cutting - - Mar 17th 2015

i was appauled when on week 4 we were given an example on how to fill in the pot sheet, the excample was that a boyfriend was late at pot level 4 they began searching for a razon and at level 5 were cutting.

I said this is a trigger, this is a bit over the top. next day phone call to ask me to meet cpn and phycologist....... this stepps programme is not for me as I dont self harm ?????

I feel cheated out of the programme which was a great help to me althought i was finding it difficult with the homework as id only been diagnosed a couple of months before this class.

im lead to beleive this is the first time a class like this has been done in glasgow scotland uk

STEPPS - Jamie - Mar 14th 2010

Stepps has worked wonders in my life and has probably saved my life.  If anyone is suffering from pretty much any mental illness (it doesn't have to be BPD), this program can help you.  Look into if there's anywhere around you that is holding this program.  You won't regret it.

Dependent Personality Disorder - Saya - Oct 29th 2009

What are the best treatments for Dependent Personality and Avoidance Personality Disorders?

mental - habatul - Oct 27th 2009

may i know,how can someone wii be describe as mental problem? and it'ssame wit mental illness?

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