Dialectic behavioral therapy for borderline personality disorder in standard medical care -: the Saarbrucken Treatment Program

Background: Dialectic behavioral therapy (DBT) is a well evaluated psychotherapeutic approach for patients with borderline personality disorder and has proved to be effective in inpatient as well as outpatient care. The Saarbrucken DBT Treatment Program is an adaptation of inpatient DBT to a standard medical care setting. Duration of inpatient treatment is reduced and no specialized borderlineward is involved. Patients and Methods: 24 patients with borderline personality disorder participated in the Saarbrucken DBT Treatment Program and were evaluated in an uncontrolled pre-post-study. Results: Results showed strong and sufficiently high effects in the reduction of self-mutilations and clinical parameters such as depression, anxiety, and general symptom distress. Only a slight reduction was achieved in trait anger. Comparisons with treatment effects reported by the DBT team at the Borderline Research Unit in Freiburg revealed no substantial differences in treatment efficacy between Freiburg and Saarbrucken. Our results suggest that the Saarbrucken DBT Treatment Program is as effective as the Freiburg DBT Program even with reduced duration of inpatient stay and without a specialized borderline ward. Discussion: A model comprising initial intensive DBT in a hospital of standard medical care and following outpatient DBT is suggested. DBT networks could be helpful to connect inpatient and outpatient treatments for patients with borderline personality disorder.