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Published Online: 1 September 2012

Use of Dialectical Behavior Therapy in Inpatient Treatment of Borderline Personality Disorder: A Systematic Review

Abstract

Objective:

Dialectical behavior therapy (DBT) is an empirically supported treatment for outpatients with borderline personality disorder. However, the utility of DBT strategies for inpatients with the disorder is unclear. This review summarizes and synthesizes findings from trials of DBT in inpatient settings.

Methods:

Multiple research databases were searched for articles published through June 2011 that reported on any implementation of DBT in an inpatient setting to address symptoms related to borderline personality disorder, including suicidal and self-injurious behavior.

Results:

Eleven studies that reported pre- and posttreatment symptoms related to borderline personality disorder were evaluated. Studies indicated that many variations of standard DBT have been used in inpatient settings, including approaches that do not include phone consultation, that include group therapy only, and that vary in treatment duration (from two weeks to three months). Most studies reported reductions in suicidal ideation, self-injurious behaviors, and symptoms of depression and anxiety, whereas results for reducing anger and violent behaviors were mixed. Follow-up data indicated that symptom reduction was often maintained between one and 21 months posttreatment. On the basis of the evidence, the authors identify essential components of an inpatient DBT package and discuss its potential function as an “intensive orientation” to outpatient DBT services.

Conclusions:

There is considerable variation in the configuration and duration of DBT implementation for inpatients with borderline personality disorder. However, findings suggest that DBT may be effective in reducing symptoms related to borderline personality disorder in inpatient settings. Future research should standardize and systematically test inpatient DBT. (Psychiatric Services 63:881–888, 2012; doi: 10.1176/appi.ps.201100311)

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Table 1 Assessment of bias risk in 11 studies of dialectical behavior therapy in inpatient settings

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Go to Psychiatric Services
Go to Psychiatric Services
Cover: Candy Apples, by Wayne Thiebaud, 1964/1990. Watercolor over hand-ground and dry-point etching, 5 × 5 inches. Gift of Mr. and Mrs. Paul LeBaron Thiebaud, 1996.19. Kemper Museum of Contemporary Art, Kansas City, Missouri.
Psychiatric Services
Pages: 881 - 888
PubMed: 22751905

History

Published online: 1 September 2012
Published in print: September 2012

Authors

Details

Jill Myerow Bloom, M.A.
The authors are affiliated with the Department of Psychology, Suffolk University, 41 Temple St., 6th Floor, Boston, MA 02114 (e-mail: [email protected]).
Eva N. Woodward, M.A.
The authors are affiliated with the Department of Psychology, Suffolk University, 41 Temple St., 6th Floor, Boston, MA 02114 (e-mail: [email protected]).
Teresa Susmaras, M.A.
The authors are affiliated with the Department of Psychology, Suffolk University, 41 Temple St., 6th Floor, Boston, MA 02114 (e-mail: [email protected]).
David W. Pantalone, Ph.D.
The authors are affiliated with the Department of Psychology, Suffolk University, 41 Temple St., 6th Floor, Boston, MA 02114 (e-mail: [email protected]).

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