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.
METHOD: 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.