Use of dialectical behavior therapy in borderline personality disorder: a view from residency.
OBJECTIVE
The authors describe the use of dialectical behavior therapy (DBT) in treating borderline personality disorder during psychiatry residency, and assess the status of DBT education within psychiatry residencies in the United States.


METHODS
The authors present a patient with borderline personality disorder treated by a resident using DBT, along with perspectives from the resident's supervisors. Additionally, self-report surveys inquiring about the attitudes and experiences of residency directors and PGY-4 residents regarding DBT were sent to program directors with available e-mail addresses on FREIDA online.


RESULTS
The DBT method employed by the resident had to be modified to fit the constraints of a residency program. The patient in therapy had a tumultuous course, ultimately resulting in the discontinuation of treatment. Survey results suggested an underemphasis on the education and use of DBT during residency, though the strength of this conclusion is limited by the small proportion of surveys returned.


CONCLUSIONS
Achieving the efficacy of DBT-based treatment of borderline personality disorder reported in the literature in the setting of a residency program is challenging. Greater exposure to DBT during residency may increase residents' skills in using the technique and the likelihood that they will use it after residency.
Sharma
Binali
B
Emory University School of Medicine, Atlanta, Georgia, USA.
Dunlop
Boadie W
BW
Ninan
Philip T
PT
Bradley
Rebekah
R
D000223:Adaptation, Psychological; D000328:Adult; D001291:Attitude of Health Personnel; D001521:Behavior Therapy / Q000193:education*; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003024:Clozapine / Q000627:therapeutic use; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003887:Desensitization, Psychologic; D003987:Dibenzothiazepines / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D018451:Homosexuality, Male / Q000523:psychology; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009042:Motivation; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D010348:Patient Care Team; D011570:Psychiatry / Q000193:education*; D000069348:Quetiapine Fumarate; D016896:Treatment Outcome
D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate; D003024:Clozapine