Dialectical behavior therapy in the treatment of persons with borderline personality disorder.

Highly suicidal, borderline patients are difficult to treat within the hospital and the community. The institution of managed care necessitates that care for these and other chronically hospitalized populations take place in the community. Psychotherapy has shown moderate success for some borderlines, however, treatment attrition is a significant problem. Without an intervention that successfully maintains suicidal borderline patients in therapy, either more costly methods of treatment must be used or death will result. A form of cognitive-behavioral therapy called dialectical behavior therapy has shown a high rate of effectiveness in reducing inpatient hospital days, suicide attempt frequency, and therapy attrition.