{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:20:37Z","timestamp":1790666437528,"version":"4.1.0"},"reference-count":47,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:00:00Z","timestamp":1640131200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100016386","name":"Conselleria d'innovaci\u00f3, universitats, ci\u00e8ncia i societat digital","doi-asserted-by":"publisher","award":["GV\/2019\/148"],"award-info":[{"award-number":["GV\/2019\/148"]}],"id":[{"id":"10.13039\/501100016386","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003176","name":"Ministerio de Educaci\u00f3n Cultura y Deporte","doi-asserted-by":"publisher","award":["FPU17\/04210"],"award-info":[{"award-number":["FPU17\/04210"]}],"id":[{"id":"10.13039\/501100003176","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The COVID-19 pandemic has had a significant impact on the family environment due to the difficulties that have been generated by job losses, deaths, increase rates of family and domestic violence, poor mental health outcomes, and estrangement in personal relationships. \u201cFamily Connections\u201d (FC) is an internationally renowned DBT-based program that supports the families and caregivers of people with borderline personality disorder. The study took place at a Specialized Health Centre in Spain. A focus group with seven participants was organized for people who had previously attended an FC group. The participants were asked about their experiences during the confinement periods that was caused by COVID-19 as well as their experiences and opinions on relatives, skills practiced, their need to and the advantages of attending the group, and satisfaction with the FC group. The qualitative research web program Dedoose was used for the thematic analysis of the data. The results showed that the participants experienced various experiences during confinement; validation and radical acceptance were determined to be the most useful skills; the importance of professionals and the content as well as the sincerity of attendees and having a safe space were determined to be the greatest benefits of the programs; and the participants all indicated great satisfaction of the program. This study allowed us to explore the experiences of family members of people with BPD with their loved ones during the confinement period caused by the COVID-19 pandemic. We evaluated the use of the FC program skills in the family environment during confinement, and we analyzed the acceptability and satisfaction with the FC program.<\/jats:p>","DOI":"10.3390\/ijerph19010079","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T10:24:52Z","timestamp":1640168692000},"page":"79","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["\u201cFamily Connections\u201d, a DBT-Based Program for Relatives of People with Borderline Personality Disorder during the COVID-19 Pandemic: A Focus Group Study"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0995-6661","authenticated-orcid":false,"given":"Isabel","family":"Fern\u00e1ndez-Felipe","sequence":"first","affiliation":[{"name":"Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, 12071 Castell\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4398-4014","authenticated-orcid":false,"given":"Amanda","family":"D\u00edaz-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Psychology and Sociology, Universidad de Zaragoza, 44003 Teruel, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1545-6452","authenticated-orcid":false,"given":"Jos\u00e9 Heliodoro","family":"Marco","sequence":"additional","affiliation":[{"name":"Departamento de Personalidad, Evaluaci\u00f3n y Tratamiento Psicol\u00f3gico, Facultad de Psicolog\u00eda, Universitat de Valencia, 46010 Valencia, Spain"},{"name":"CIBER Fisiopatolog\u00eda Obesidad y Nutrici\u00f3n (CB06\/03), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azucena","family":"Garc\u00eda-Palacios","sequence":"additional","affiliation":[{"name":"Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, 12071 Castell\u00f3n, Spain"},{"name":"CIBER Fisiopatolog\u00eda Obesidad y Nutrici\u00f3n (CB06\/03), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica","family":"Guill\u00e9n Botella","sequence":"additional","affiliation":[{"name":"Departamento de Personalidad, Evaluaci\u00f3n y Tratamiento Psicol\u00f3gico, Facultad de Psicolog\u00eda, Universitat de Valencia, 46010 Valencia, Spain"},{"name":"CIBER Fisiopatolog\u00eda Obesidad y Nutrici\u00f3n (CB06\/03), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e32","DOI":"10.1192\/j.eurpsy.2020.35","article-title":"The consequences of the COVID-19 pandemic on mental health and implications for clinical practice","volume":"63","author":"Fiorillo","year":"2020","journal-title":"Eur. Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1002\/wps.20766","article-title":"Psychiatry in the age of COVID-19","volume":"19","author":"Kimmel","year":"2020","journal-title":"World Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1038\/s41586-020-2404-8","article-title":"The effect of large-scale anti-contagion policies on the COVID-19","volume":"584","author":"Hsiang","year":"2020","journal-title":"Nature"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e76","DOI":"10.1056\/NEJMp2021209","article-title":"COVID-19 and health equity\u2014Time to think big","volume":"383","author":"Berkowitz","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/S0140-6736(20)30893-X","article-title":"COVID-19 exacerbating inequalities in the US","volume":"395","author":"Cooney","year":"2020","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1001\/jamapediatrics.2020.2065","article-title":"Low-income children and coronavirus disease 2019 (COVID-19) in the US","volume":"174","author":"Dooley","year":"2020","journal-title":"JAMA Pediatr."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"CDC COVID-19 Response Team (2020). Geographic differences in COVID-19 cases, deaths, and incidence\u2014United States, February 12\u2013April 7, 2020. Morb. Mortal. Wkly. Rep., 69, 465\u2013471.","DOI":"10.15585\/mmwr.mm6915e4"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1056\/NEJMp2008017","article-title":"Mental health and the Covid-19 pandemic","volume":"383","author":"Pfefferbaum","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S0140-6736(20)30460-8","article-title":"The psychological impact of quarantine and how to reduce it: Rapid review of the evidence","volume":"395","author":"Brooks","year":"2020","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.bbi.2020.05.048","article-title":"COVID-19 pandemic and mental health consequences: Systematic review of the current evidence","volume":"89","author":"Vindegaard","year":"2020","journal-title":"Brain Behav. Immun."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1111\/famp.12347","article-title":"The solace of an uncertain future: Acute illness, the self, and self-care","volume":"57","author":"Weingarten","year":"2018","journal-title":"Fam. Process"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Minuchin, S. (1974). Families & Family Therapy, Harvard University Press.","DOI":"10.4159\/9780674041127"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1111\/famp.12235","article-title":"Family Interventions for Schizophrenia and the Psychoses: A Review","volume":"55","author":"McFarlane","year":"2016","journal-title":"Fam. Process"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/j.1365-2850.1994.tb00038.x","article-title":"Concept and models for the study of caregiver burden","volume":"1","author":"Loukissa","year":"1994","journal-title":"J. Psychiatry Ment. Health Nurs."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1521\/pedi.2008.22.3.233","article-title":"How do personality disorders modify suicide risk?","volume":"22","author":"Schneider","year":"2008","journal-title":"J. Pers. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1176\/appi.ajp.158.2.295","article-title":"Treatment utilization by patients with personality disorders","volume":"158","author":"Bender","year":"2001","journal-title":"Am. J. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.genhosppsych.2011.04.006","article-title":"Utilization of primary care physicians in borderline personality","volume":"33","author":"Sansone","year":"2011","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"259","DOI":"10.4088\/JCP.v69n0212","article-title":"The economic burden of personality disorders in mental health care","volume":"69","author":"Soeteman","year":"2008","journal-title":"J. Clin. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Meuldijk, D., McCarthy, A., Bourke, M., and Grenyer, B. (2017). The value of psychological treatment for borderline personality disorder: Systematic review and cost offset analysis of economic evaluations. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0171592"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Amianto, F., Ferrero, A., Piero, A., Cairo, E., Rocca, G., and Simonelli, B. (2011). Supervised team management, with or without structured psychotherapy, in heavy users of a mental health service with borderline personality disorder: A two-year follow-up preliminary randomized study. BMC Psychiatry, 11.","DOI":"10.1186\/1471-244X-11-181"},{"key":"ref_21","unstructured":"Dimeff, L., and Koerner, K. (2007). Dialectical Behaviour Therapy in Clinical Practice. Applications across Disorders and Settings, Guildford Press."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1017\/S0954579405050479","article-title":"Family interaction and the development of borderline personality disorder: A transactional model","volume":"17","author":"Fruzzetti","year":"2005","journal-title":"Dev. Psychopathol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/0277-9536(87)90229-2","article-title":"Living with psychiatric patients: Implications for the mental health of family members","volume":"25","author":"Noh","year":"1987","journal-title":"Soc. Sci. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1007\/s11920-007-0012-z","article-title":"Advances in interventions for families with a relative with a personality disorder diagnosis","volume":"9","author":"Hoffman","year":"2007","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1521\/pedi.1988.2.1.14","article-title":"The occurrence of borderline personality disorder in the families of borderline patients","volume":"2","author":"Links","year":"1988","journal-title":"J. Pers. Disord."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1001\/archpsyc.1983.01790010025003","article-title":"The validity of DSM-III borderline personality disorder","volume":"40","author":"Pope","year":"1983","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1111\/j.1545-5300.1999.00399.x","article-title":"Dialectical behavior therapy-family skills training","volume":"38","author":"Hoffman","year":"1999","journal-title":"Fam. Process"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/j.1545-5300.2003.00469.x","article-title":"Family members\u2019 knowledge about borderline personality disorder: Correspondence with their levels of depression, burden, distress and expressed emotion","volume":"42","author":"Hoffman","year":"2003","journal-title":"Fam. Process"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1080\/13811110903044401","article-title":"Dialectical behavior therapy-based skills training for family members of suicide attempters","volume":"13","author":"Rajalin","year":"2009","journal-title":"Arch. Suicide Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1176\/appi.ps.52.7.903","article-title":"Evidence-based practices for services to families of people with psychiatric disabilities","volume":"52","author":"Dixon","year":"2001","journal-title":"Psychiatr. Serv."},{"key":"ref_31","first-page":"134","article-title":"Interventions for Family Members and Carers of Patients with Borderline Personality Disorder: A Systematic Review","volume":"60","author":"Mira","year":"2020","journal-title":"Fam. Process"},{"key":"ref_32","unstructured":"Linehan, M. (1993). Diagnosis and Treatment of Mental Disorders. Cognitive-Behavioral Treatment of Borderline Personality Disorder, Guildford Press."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1146\/annurev-clinpsy-032210-104449","article-title":"Open, aware, and active: Contextual approaches as an emerging trend in the behavioral and cognitive therapies","volume":"7","author":"Hayes","year":"2011","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1111\/j.1545-5300.2005.00055.x","article-title":"Family connections: A program for relatives of persons with borderline personality disorder","volume":"44","author":"Hoffman","year":"2005","journal-title":"Fam. Process"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s40479-017-0069-1","article-title":"Family connections versus family connections versus optimised treatment-as-usual for family members of individuals with borderline personality disorder: Non-randomised controlled study","volume":"4","author":"Flynn","year":"2017","journal-title":"Bord. Personal. Disord. Emot. Dysregul."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.apnu.2014.03.002","article-title":"Family skills training in dialectical behavior therapy: The experience of the significant others","volume":"28","author":"Ekdahl","year":"2014","journal-title":"Arch. Psychiatr. Nurs."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s40479-019-0111-6","article-title":"Family Connections in different settings and intensities for underserved and geographically isolated families: A non-randomised comparison study","volume":"6","author":"Liljedahl","year":"2019","journal-title":"Bord. Personal. Disord. Emot. Dysregul."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1007\/s10597-012-9556-4","article-title":"\u201cIt\u2019s Us That Have to Deal with it Seven Days a Week\u201d: Carers and Borderline Personality Disorder","volume":"49","author":"Dunne","year":"2013","journal-title":"Community Ment. Health J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.apnu.2011.06.005","article-title":"A life tiptoeing: Being a significant other to persons with borderline personality disorder","volume":"25","author":"Ekdahl","year":"2011","journal-title":"Arch. Psychiatr. Nurs."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"a1892","DOI":"10.4102\/curationis.v41i1.1892","article-title":"Experiences of family members who have a relative diagnosed with borderline personality disorder","volume":"41","author":"Kay","year":"2018","journal-title":"Curationis"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1375\/anft.29.3.133","article-title":"Family experience of borderline personality disorder","volume":"29","author":"Giffin","year":"2008","journal-title":"Aust. N. Z. J. Fam. Ther."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/0005-7916(72)90045-6","article-title":"Credibility of analogue therapy rationales","volume":"3","author":"Borkovec","year":"1972","journal-title":"J. Behav. Ther. Exp. Psychiatry"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int. J. Qual. Health Care"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/j.1365-2648.2007.04569.x","article-title":"The qualitative content analysis process","volume":"62","author":"Elo","year":"2008","journal-title":"J. Adv. Nurs."},{"key":"ref_45","unstructured":"(2020, September 15). Instituto Nacional de Estad\u00edstica. Available online: https:\/\/www.ine.es\/covid\/covid_inicio.htm."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1002\/wps.20803","article-title":"COVID-19 and psychiatrists\u2019 responsibilities: A WPA position paper","volume":"19","author":"Stewart","year":"2020","journal-title":"World Psychiatry"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1080\/10503300802702105","article-title":"Qualitative Research Interviews","volume":"19","author":"Knox","year":"2009","journal-title":"Psychother. Res."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/1\/79\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:51:16Z","timestamp":1760169076000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/1\/79"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,22]]},"references-count":47,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["ijerph19010079"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19010079","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,22]]}}}