Cited by 103Personality Disorders and PsychopathologyPsychotherapy Techniques and ApplicationsBipolar Disorder and Treatment

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

Bloom, Jill Myerow, Woodward, Eva N., Susmaras, Teresa, Pantalone, David W.·2012·Psychiatric Services

DOI 10.1176/appi.ps.201100311

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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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Steele, S. J., Baskin-sommers, A. R., Hearon, B. A., Gironde, S., & Björgvinsson, Þ. (2015) · Cognitive Therapy and Research · doi:10.1007/s10608-015-9726-0 · Cited by 3
“…that indicates BPD can be effectively treated following short-term CBT interventions (e.g., partial hospitalization; Neuhaus et al. 2007) and DBT interventions (e.g., inpatient hospitalization: Bloom et al. 2012; Bohus et al. 2004; Swenson et al. 2001; partial hospitalization: Simpson et al. 1998).”
BackgroundInfluential
A Three-tiered Approach for Addressing Nonsuicidal Self-injury in the Classroom
Wells, A., & Axe, J. B. (2013) · Beyond Behavior · doi:10.1177/107429561302200207 · Cited by 3
“Although there is substantial evidence for DBT with adults (Bloom & Woodward, 2012), the research is just emerging with children (Groves, Backer, van den Bosch, & Miller, 2012).”
Background
Medium-term Effects of Intensified Inpatient Dialectical Behavior Therapy on Psychosocial Outcomes
Mikusky, D., Sanhüter, N., Bauer, J., Macchia, A., Nickel, S., & Abler, B. (2025) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000864 · Cited by 2
The cultural change narrative as a core component of therapeutic change
Tobiassen, A. H., Sundal, T., Stänicke, E., & Folmo, E. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1149984 · Cited by 2
Positive Suicidology: Promoting Well-Being and Addressing Suicide
Arora, S., & Sharma, V. (2025) · Springer eBooks · doi:10.1007/978-981-96-1403-5_28 · Cited by 2
Personality disordered women in secure care: a treatment evaluation
Long, C. G., Dolley, O., & Hollin, C. R. (2014) · Journal of Criminal Psychology · doi:10.1108/jcp-04-2013-0009 · Cited by 2
What's New in Treating Inpatients With Personality Disorders?: Dialectical Behavior Therapy and Old-Fashioned, Good Communication
Ritter, S., & Platt, L. M. (2016) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20151216-03 · Cited by 2
Evaluation of Dialectical Behavioral Therapy on Egyptian Patients with Borderline Personality Disorder: A Comparative Study
Fnoon, N. F. M., Eissa, M. A.-R., Ramadan, E. E., El-Sawy, H. E., & El-Karim, A. M. A. A. (2023) · Journal of Advances in Medicine and Medical Research · doi:10.9734/jammr/2023/v35i195133 · Cited by 1
“[31], the effectiveness of DBT on reducing the BPD symptoms was consistent across the eleven included studies.”
The Application of Dialectical Behavior Therapy
Luo, Y. (2023) · Journal of Education Humanities and Social Sciences · doi:10.54097/ehss.v22i.12417 · Cited by 1
“The implementation of outpatient DBT is proven to be effective which suggests that the DBT in inpatient settings may also be effective in alleviating mental health problems among those who are diagnosed with BPD and admitted to inpatient psychiatric unit [5].”
Background
Patients with borderline personality disorder show initially reduced psychophysiological relaxation levels but intact relaxation response
Gaertner, R. J., Klink, E. S. C., Benz, A., Denk, B., Meier, M., Wienhold, S., Volkmer, N., Kossmann, K. E., & Pruessner, J. C. (2025) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2025.152618 · Cited by 2
Differential Therapeutic Responses to DBT Skills Training and Validation: A Case Study
Danzer, G. S., & Ferber, S. (2014) · Psychology · doi:10.4236/psych.2014.57078 · Cited by 1
“…trials, and has outperformed medication approaches in research on reducing self-injurious behavior, primarily as a result of the skills training (Bloom et al., 2012; Linehan, Armstrong, Suarez, Allmon, & Heard, 1991; Linehan, Comtois, Murray, Brown, & Gallop, 2006; Neacsiu, Rizvi, & Linehan,…”
Method
Characteristics for Low, High and Very High Emergency Department Use for Mental Health Diagnoses from Health Records and Structured Interviews.
Fleury, M., Cao, Z., & Grenier, G. (2024) · PubMed Central · doi:10.5811/westjem.18327 · Cited by 1
Changes in Emotion Regulation During the Course of Dialectical Behaviour Therapy: Effects on Non‐Suicidal Self‐Injury and Binge Eating Across Two Samples
Harris, L. M., Weiss, E. R., Davis, M. T., Daniel, T. A., Hart-Derrick, V. R., Barnes, S., & Cawood, C. D. (2024) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70018 · Cited by 2
Substance Abuse and Animal Maltreatment
Levitt, L. (2023) · Wiley eBooks · doi:10.1002/9781119894131.ch14 · Cited by 1
The relevance of different patterns of instability in the treatment of borderline personality disorder - results of the Basel borderline inpatient study (BABIS)
Gremaud-Heitz, D. J. (2015) · edoc (University of Basel) · doi:10.5451/unibas-006385023
Implementazione della DBT in un Servizio per le Tossicodipendenze: l’inevitabile ricerca di una sintesi tra sistemi
Bonfà, F., Cabrini, S., Draisci, A., Limonta, G., Spotti, R., & Uber, E. (2014) · RIVISTA SPERIMENTALE DI FRENIATRIA · doi:10.3280/rsf2014-003012
Attention-Deficit/Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD): Examining the overlapping features, co-occurrence, and sex differences
Lewno, B. (2014) · UNI ScholarWorks (University of Northern Iowa)
Le trouble de la personnalité borderline constitue-t-il un facteur prédictif de récidive suicidaire ?
Tolfo, P. (2015) · HAL
Stellenwert des Opioidantagonisten Naltrexon bei stationär behandelten Borderline-Patienten
Meiser, M. (2016) · doi:10.53846/goediss-5868
Dialectical Behavior Therapy on Borderline Personality Disorder
Cook, A. M. (2018) · UND Scholarly Commons (University of North Dakota)
Transferred Focused Psychotherapy vs Dialectical Behaviour Therapy for the treatment of Borderline Personality Disorder: Α review of the current RCT-based literature
Tsirides, A., Iliopoulou, T., & Louka, P. (2021) · Dialogues in Clinical Neuroscience & Mental Health · doi:10.26386/obrela.v4i2.159
Personality Disorder Services: Rapid Review
McCartan, C. J., & Davidson, G. (2020) · Research Portal (Queen's University Belfast)
L'integrazione come archetipo della trasformazione dell'OPG di Castiglione delle Stiviere in Sistema Polimodulare di REMS
Redazione (2017) · RIVISTA SPERIMENTALE DI FRENIATRIA · doi:10.3280/rsf2017-001005
Bibliography: Personality Disorders
(2013) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.11.2.214
Теорія та практика діалектико-поведінкової терапії
Andrushko, Y. (2022) · Insight the psychological dimensions of society · doi:10.32999/2663-970x/2022-8-2
Dialectical Behavioral Therapy on an Inpatient Psychiatry Consult Service
Carmel, A., & Robins, C. J. (2023) · Academic Psychiatry · doi:10.1007/s40596-023-01866-7
Dialectical behaviour therapy for men and boys: A systematic review
Holah, S., Maguire, N., & Bennetts, A. (2023) · Counselling and Psychotherapy Research · doi:10.1002/capr.12702 · Cited by 1
“…post-traumatic stress disorder (Bohus et al., 2013), drug dependence and substance use (Courbasson et al., 2012), binge eating disorder (Telch et al., 2001) and other populations, including psychiatric inpatients (Bloom et al., 2012) and those with intellectual disabilities (McNair et al., 2017).”
References
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Quantitative evidence for relational care approaches to assessing and managing self-harm and suicide risk in inpatient mental health and emergency department settings: a scoping reviewPreprint
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Cross-sectional examination of therapy knowledge and preferred sources among American adults not receiving mental healthcare
Rodriguez, T. R., Bond, A. E., Anestis, M. D., & Anestis, J. C. (2025) · Patient Education and Counseling · doi:10.1016/j.pec.2025.109187
Significant Events Experienced by Psychiatric Patients With Personality Disorders in Inpatient Settings: A Qualitative Study and Implications for Clinical Management
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Acute effects of inpatient brief cognitive-behavioral therapy for suicide prevention on non-suicidal self-injury: Exploring the association with improved distress tolerance
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Sequential Treatment of Borderline Personality Disorder and PTSD Utilizing Dialectical Behavior Therapy and Cognitive Processing Therapy in a Veteran Sample
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Authors: Bloom, J. M., Woodward, E. N., Susmaras, T., & Pantalone, D. W.
Affiliations: Suffolk University (US)
ORCID: Woodward, Eva N.
Pantalone, David W.
Venue: Psychiatric Services
Publisher: American Psychiatric Association Publishing
Published: 2012-09
Volume: 63
Issue: 9
Pages: 881-888
ISSN: 0022-1597 (ISSN-L)
1075-2730
1557-9700
DOI: 10.1176/appi.ps.201100311
OpenAlex: W2101656487
Semantic Scholar: 23306a10e405ba10db966e765de568760b23edcb
Cited by: 103
References: 51
Citations by year: 2026: 5 · 2025: 11 · 2024: 12 · 2023: 7 · 2022: 7 · 2021: 12 · 2020: 5 · 2019: 8 · 2018: 9 · 2017: 3 · 2016: 7 · 2015: 4 · 2014: 8 · 2013: 5
FWCI: 0.79
Type: journal article
Language: en
Open access: closed
Locations: Psychiatric Services (publishedVersion)
PubMed (publishedVersion)
Funders: Department of Biotechnology, Ministry of Science and Technology, India
Topics: Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords: dialectical behavior therapy, borderline personality disorder, inpatient care, suicidal ideation, self-harm, depression, anxiety, anger, violence, telephone consultation, group therapy, treatment duration, symptom maintenance, intensive outpatient treatment
MeSH terms: Behavior Therapy, Borderline Personality Disorder, Female, Humans, Male

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

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