Acceptability and Feasibility of a Taekwondo Mindful Movement Intervention in Dialectical Behavior Therapy

Borderline personality disorder (BPD) is often comorbid with disordered eating behaviors. Effective treatments are critically needed for this complex population. Mindful movement interventions may represent a promising, adjunctive treatment option for individuals with BPD symptoms, especially those with co-occurring disordered eating. Previous work has demonstrated that Taekwondo, a Korean martial art emphasizing mind-body connections, is an acceptable and feasible candidate intervention. This pilot study (N = 24, 79.2% female, Mage = 31.2; 75.0% white) examined acceptability and feasibility of a Taekwondo and Mindfulness intervention in a Dialectical Behavior Therapy (DBT) intensive outpatient program (IOP) using a within-subjects design. Patients consistently rated Taekwondo groups highly regarding average satisfaction and effectiveness (3.6-4.7/5), and showed significant state-level improvements in anxiety (p = .001. d = 0.76), sadness (p = .002, d = 0.74), happiness (p < .001, d = -0.86), and relaxation (p < .001, d = -0.96) following group participation. Conversely, significant changes in sadness (p = .082, d = 0.40) and happiness (p = .078, d = -0.41) were not observed following Comparison Groups (Traditional Mindfulness). Binge-eating frequency was correlated with greater reductions in sadness (r = .41, p = .041) following Taekwondo groups, but not Comparison Groups (r = .01, p=.977). Compared to non-purging individuals, patients reporting purging showed greater increases in happiness following Taekwondo groups (p = .024, d = 1.23), but smaller increases following Comparison Groups (p = .037, d = -1.24). Together, preliminary findings suggest an additive benefit of Taekwondo as a mindful movement adjunct to treatment.