Integrating peer support in the treatment of personality disorders: current evidence and dimensional perspective

Peer support interventions have emerged as a promising adjunct to the treatment of personality disorders, particularly borderline personality disorder (BPD). This review summarizes the rapidly expanding literature on peer support in personality disorders and proposes a dimensional reinterpretation of its potential mechanisms of action through dimensional models of personality functioning.

Recent literature supports the feasibility, acceptability, and preliminary efficacy of peer support interventions in BPD. Benefits have been reported across recovery-related outcomes, including validation, hope, empowerment, social connectedness, emotion regulation, and, more recently, BPD symptoms and personality functioning. Despite these advances, evidence remains almost exclusively restricted to BPD. Reinterpreting literature through a dimensional framework suggests that the therapeutic processes most consistently reported may influence core domains of personality functioning, including identity, self-direction, empathy, and intimacy.

Peer support is a feasible and promising complement to evidence-based treatments for personality disorders, provided that adequate training, supervision, role clarity, and organizational support are ensured. A dimensional perspective offers a coherent framework for understanding its potential transdiagnostic relevance by targeting impairments in personality functioning rather than diagnosis-specific symptoms. Future research should extend investigations beyond BPD and clarify the mechanisms through which peer support contributes to recovery.