Kramer 2011.

Study characteristics
Methods	10‐week trial with 2 arms Motive‐oriented therapeutic relationship + treatment as usual (MOTR + TAU) Treatment‐as‐usual (TAU) Duration of trial: 10 weeks Country: Switzerland Setting: outpatient clinic
Participants	Method of recruitment of participants: not stated Sample size: 25 Diagnosis of borderline personality disorder: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM‐IV) Means of assessment: Structured Clinical Interview for DSM‐IV Axis II Disorders (SCID‐II) Mean age: MOTR + TAU = 30.29 years (standard deviation = 12.43), TAU = 31.27 years (standard deviation = 8.21) Sex: 77% female Comorbidity: panic disorder, agoraphobia, alcohol abuse, major depression, bulimia, anorexia, somatoform disorder Inclusion criteria Main diagnosis of borderline personality disorder Between 18 and 60 years old Able to speak French Exclusion criteria An organic disorder A persistent substance abuse/dependence that might affect brain function (memory, level of consciousness, cognitive abilities) A psychotic disorder implying pronounced break in reality testing (chronic or intermittent), such as schizophrenia, delusional disorder, bipolar affective disorder I An acute risk of suicide Severe cognitive impairment
Interventions	Experimental group Treatment name: MOTR + TAU Number randomised to group: 11 Duration: 10 weeks Concomitant psychotherapy: not stated Concomitant pharmacotherapy: not stated Control/comparison group Comparison name: TAU Number randomised to group: 14 Duration: 10 weeks Concomitant psychotherapy: not stated Concomitant pharmacotherapy: If necessary, short‐term inpatient treatment was organised, as was adjunct pharmacotherapy Proportions of participants taking standing psychotropic medication during trial observation period: unclear
Outcomes	Primary Psychosocial functioning, assessed by social role subscale of the Outcome Questionnaire ‐ 45.2 (OQ‐45) Secondary Interpersonal problems, assessed by the interpersonal problem subscale of OQ‐45 Attrition, in terms of patients lost after randomisation in each group
Notes	Sample size calculation: not stated Ethics approval: The study was approved by the Ethics Committee of the Psychiatric Department involved. All patients gave written consent for the data to be used for research purposes. Comments from review authors: none
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Comment: randomisation was performed by blocks of 10 participants, using a computer‐based program
Allocation concealment (selection bias)	Low risk	Comment: The preparation of sealed envelopes containing information on the condition for each participant was done by an independent researcher.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Comment: raters were unaware of the treatment condition.
Incomplete outcome data (attrition bias) All outcomes	High risk	Comment: in case of missing values, LOCF used. The process analyses were carried out on a restricted sample of 20 patients (TAU = 10; MOTR +TAU = 10), due to missing values (related to early terminations) of 5 individuals having completed too few sessions to be taken into account.
Selective reporting (reporting bias)	High risk	Comment: Borderline Symptoms List reported in the protocol did not appear in the publication.
Other bias	High risk	Allegiance bias Comment: Casper involved in the development of analysis plan Attention bias Comment: To counterbalance the increased time investment in condition 2, the therapists in condition 1 filled in a summary form on the patient’s symptoms and problems.