Abstract
Borderline personality disorder (BPD) is a complex mental illness characterized by emotional instability, impulsivity, and unstable relationships. Individuals with BPD often require frequent hospitalizations and experience significant functional impairment. With increasing BPD admissions, Spencer Hospital seeks evidence-based strategies to improve patient outcomes and reduce readmissions. A literature review of ten studies (2016-2025) was conducted using PubMed, CINAHL, and Science Direct, appraised with the Johns Hopkins Nursing Evidence-Based Practice Model to compare inpatient and outpatient treatments for adults with BPD, focusing on symptom manage and quality of life. Findings indicate inpatient care with specific programs such as dialectical behavior therapy (DBT), mentalization-based therapy (MBT), and schema therapy to support crisis stabilization and skill building. However, long-term improvements in emotion regulation and reduced readmissions are most consistent in outpatient DBT and MBT programs. The evidence supports a combined approach that begins with inpatient treatment for acute stabilization and leads to structured outpatient therapy for long-term recovery. Using the Tidal Model, this plan emphasizes patient-centered care, reduces symptoms, and improves quality of life.
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Inpatient Treatment Compared to Outpatient Treatment for Borderline Personality Disorder
Borderline personality disorder (BPD) is a complex mental illness characterized by emotional instability, impulsivity, and unstable relationships. Individuals with BPD often require frequent hospitalizations and experience significant functional impairment. With increasing BPD admissions, Spencer Hospital seeks evidence-based strategies to improve patient outcomes and reduce readmissions. A literature review of ten studies (2016-2025) was conducted using PubMed, CINAHL, and Science Direct, appraised with the Johns Hopkins Nursing Evidence-Based Practice Model to compare inpatient and outpatient treatments for adults with BPD, focusing on symptom manage and quality of life. Findings indicate inpatient care with specific programs such as dialectical behavior therapy (DBT), mentalization-based therapy (MBT), and schema therapy to support crisis stabilization and skill building. However, long-term improvements in emotion regulation and reduced readmissions are most consistent in outpatient DBT and MBT programs. The evidence supports a combined approach that begins with inpatient treatment for acute stabilization and leads to structured outpatient therapy for long-term recovery. Using the Tidal Model, this plan emphasizes patient-centered care, reduces symptoms, and improves quality of life.