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Recap: The BEST study

Logo for BEST study

What we did and why we did it

The BEST (Brief Education Supported Treatment) study explored a new approach to supporting young people who had early symptoms of borderline personality disorder (BPD). Symptoms of BPD include unstable emotions, difficulties getting along with others, risky behaviour and self-harm. The BEST approach involved mental health services working together with schools and colleges to jointly deliver and test a short intervention. This study aimed to find out whether this new joint approach to providing support was practical, liked by staff and young people, and whether it would be possible to run a larger study in the future. Students aged 13-18 years with symptoms of BPD were allocated at random to either receive the BEST intervention or standard care. Information was collected to assess whether it would be possible to run a future larger trial.

Take away points

  • The BEST intervention was delivered successfully within schools and colleges and valued by staff and young people. It represents a promising approach to access timely support for young people who are experiencing BPD symptoms.
  • While the findings of this study provide support for progressing to a larger trial, they also highlighted several changes that would need to be made to make a larger trial successful.

What we found

We found that it is possible to deliver the BEST intervention within schools and colleges. Feedback from staff and young people suggested that the intervention was popular, and was viewed as potentially beneficial for young people, staff involved in co-delivery, and the wider school or college. But most referrals came directly from schools and colleges rather than the NHS, so when schools closed due to COVID-19, the study was cut short. These findings suggest that a larger trial testing whether the BEST intervention leads to improved outcomes and offers value for money would be worthwhile. But the study also identified several practical changes that would be needed in order for a future trial to be successful.

What’s Next?

We plan to use the learning from this study, together with some more work, to design a larger trial of how well the BEST intervention works. We intend to apply for further funding later this year to start this work.

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