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Borderline Personal Disord Emot Dysregul. 2014 Dec 18;1:20. doi: 10.1186/2051-6673-1-20. eCollection 2014.

Effectiveness of dialectic behavioral therapy in routine outpatient care: the Berlin Borderline Study.

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Arbeitsgemeinschaft fuer Wissenschaftliche Psychotherapie, Witzlebenstraβe 30a, 14057 Berlin, Germany.
Department of Psychology, Humboldt-Universitaet zu Berlin, Unter den Linden 6, 10999 Berlin, Germany.
Department of Psychology, Freie Universitaet Berlin, Habelschwerdter Allee 45, 14195 Berlin, Germany.
Department of Psychiatry, Charité, Universitaetsmedizin Berlin, Campus Benjamin Franklin, Eschenallee 3, 14050 Berlin, Germany.
Department of Psychiatry, Charité, Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany.



Dialectical behavior therapy (DBT) has been proven to be an efficacious treatment for borderline personality disorder (BPD) in several randomized controlled trials (RCTs). However, generalizability of this outcome to the routine health care (effectiveness) has rarely been investigated to date. The aim of this study is to examine the effectiveness of DBT for BPD under the routine health care situation in Germany.


The study has a longitudinal design over a course of four years with six assessment points. In this paper, results for the first year of treatment are reported. Outcome was assessed at four times throughout an initial phase (of up to five therapy-sessions) and an additional 12 months of therapy. Overall, n =78 patients started the study, 47 patients completed one year of treatment. Dependent variables were number and duration of inpatient treatment stays, number of suicide attempts and non-suicidal self-injury, severity of borderline symptoms, depression, level of dissociation, and general psychopathology.


Patients significantly improved regarding self-injurious behaviors, number of inpatient hospital stays, severity of borderline symptoms and psychopathology. At the end of the first treatment year, 77% of the patients no longer met criteria for BPD diagnosis. Fewer therapy discontinuations by patients were observed when therapists participated in consultation teams.


Under routine mental health care conditions in Germany, outpatient DBT leads to positive results comparable to those reported in other effectiveness studies and in randomized controlled trials.


Borderline personality disorder; Dialectical behavior therapy; Effectiveness study

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