FOCUSED TIME-LIMITED INPATIENT TREATMENT OF BORDERLINE PERSONALITY-DISORDER

This paper describes a model for the short-term, time-limited inpatien t treatment of patients with borderline personality disorder on a gene ral psychiatry inpatient unit. The model includes many structural elem ents believed necessary for the successful short-term inpatient treatm ent of borderline patients such as preadmission contracts, a goal-orie nted inpatient behavioral treatment contract, a focus on reducing symp toms related to the current crisis, the setting early in hospitalizati on of a discharge date, and the delineation of specific goal-oriented criteria for readmission. The model combines these ''structures'' with an adaptation to the short-term of a specific cognitive-behavioral ap proach, Dialectical Behavioral Therapy as developed by Marsha Linehan. This 7- to 14-day treatment model appears to (1) prevent regression i n the patient and (2) help the patient to become a partner in and take responsibility for progress during the inpatient stay.