Several mobile phone applications have been developed for people with BPD, mostly for use as adjuncts to DBT. Research examining their acceptability, feasibility and preliminary effectiveness appear promising, but none have undergone rigorous evaluation. Only one, DBT Coach, has been examined among people with co-occurring AOD use disorders.
DBT Coach is a mobile phone application designed to improve the generalisation of specific skills taught in DBT. In a pilot study of the feasibility, acceptability, and effectiveness of DBT Coach among people with co-occurring BPD and AOD use disorders, participants found the application to be helpful and easy to use, and over the course of the study, there was a decrease in depression, emotion intensity, and urges to use AOD [1535]. A second study that evaluated DBT Coach among people with single disorder BPD also found reductions in subjective ratings of distress and urges to self-harm, but borderline symptoms and emotional regulation did not improve [1536].
Other mobile phone applications developed for BPD include EMOTEO, mDiary and Monsenso’s mHealth for Mental Health module for BPD. EMOTEO targets emotion regulation through engagement with mindfulness or distraction exercises that are matched to the user’s level of distress. An initial pilot study found that people using the app reported high levels of satisfaction, and that the application reduced aversive tension over time [1537]. mDiary and Monsenso’s mHealth for Mental Health BPD modules provide the opportunity for mood, symptom, medication, and skills monitoring, alongside changes in BPD symptoms [1538, 1539]. Although interviews with people who have used these apps found that users viewed the app as being user-friendly [1538], and helped in facilitating access to, and helping them implement, DBT strategies [1539], outcomes related to psychopathology were not assessed.
In addition to apps based on DBT, one e-health program, Priovi, a schema-therapy based intervention designed as an adjunct to individual psychotherapy, has been evaluated among people with single disorder BPD [1540]. Compared to baseline, using Priovi over 12 months was found to reduce BPD symptoms; however, some exercises provoked mild anxiety. The use of telehealth interventions has yet to be examined among people with co-occurring BPD and AOD use specifically. However, an evaluation of the use of telehealth among people with BPD as a single disorder during the recent COVID-19 pandemic suggests that the delivery of treatments such as ACT and DBT is as effective when conducted over the phone as treatment in person [1541].