Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: Borderline Personality Disorder (BPD) is a complex and pervasive mental health condition characterized by emotional instability, intense interpersonal relationships, and a fragmented self–concept. Various therapeutic approaches have been developed to address these issues, but none have been entirely successful in treating all aspects of BPD. Among the most prominent therapies are Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, which focuses on balancing acceptance and change, and Emotion–Focused Therapy (EFT), which helps individuals recognize and manage their emotions. Despite the proven effectiveness of DBT, it does not fully address the emotional core of BPD. On the other hand, EFT has shown promise in helping individuals process and regulate their emotions, making it a suitable candidate for integration with DBT to enhance therapeutic outcomes. The primary objective of this study was to assess the feasibility and content validity of an integrative therapeutic protocol combining DBT and EFT aimed at reducing the symptoms of BPD.
Methods: In this qualitative study, researchers designed a unified treatment protocol that integrated components of EFT and DBT. The protocol was developed based on a review of existing literature and consultations with experts in the field of personality disorders. The protocol included 13 sessions, each incorporating elements from DBT and EFT, focusing on emotion regulation and distress tolerance skills. To evaluate the content validity of the protocol, a panel of 12 clinical experts with extensive experience in treating personality disorders was assembled. These experts were asked to assess each session's necessity, relevance, simplicity, and clarity using a structured questionnaire. The Content Validity Index (CVI) and Content Validity Ratio (CVR) were calculated for each session to determine their validity. A CVR above 0.56 was considered acceptable, given the number of experts, while a CVI above 0.8 was considered favorable content validity.
Results: The results demonstrated that all 13 sessions of the integrative protocol had a CVR higher than 0.56, surpassing the acceptable threshold for content validity. The CVI for each session was also above 0.8 across all dimensions, indicating that the sessions were highly relevant, simple, and clear, according to the expert panel. These findings suggest that the proposed integrative treatment protocol has strong content validity from the perspective of clinical experts. The integration of EFT into DBT appears to have enriched the therapeutic process by addressing emotional regulation more effectively, thereby enhancing the overall potential of the treatment for BPD.
Conclusion: The findings of this study indicate that the integrative DBT and EFT protocol has appropriate content validity and can be considered a viable treatment option for BPD. The protocol's emphasis on emotional regulation and interpersonal skills, through the combination of DBT and EFT, offers a promising approach for future research and clinical application.