Conflicting treatment models for the inpatient management of borderline patients

The authors contrast two paradigms for long-term treatment of borderline patients: 1) modified psychoanalytic psychotherapy, which attempts to bring about structural intrapsychic change, and 2) psychotherapy that strives only to improve adaptation. They demonstrate the divergent uses of the psychiatric hospital for these two treatments and the potential for regression and hospital failure when conceptual conflict arises between inpatient and outpatient clinicians or when the hospital mixes aspects of these often antithetical treatment models.