Proposed nursing practice for DBT implementation on psychiatry inpatient units: a review and synthesis of the literature




Fankboner, Morgan Alexa

Journal Title

Journal ISSN

Volume Title



This review and synthesis of the literature focuses on Dialectical Behavior Therapy (DBT) and the feasibility of its implementation on psychiatry inpatient units by nurses. Twelve studies and one literature review were selected from the last 7 years and analyzed using the Matrix Method by Garrard (2007). The central questions were in relation to whether or not DBT can be implemented effectively: i) in psychiatric inpatient settings; and ii) with persons with Borderline Personality Disordered (BPD) who also live with comorbid conditions. The findings based on a review of the literature indicate that DBT can be implemented effectively on psychiatry inpatient units for patients with BPD and comorbid conditions. Preliminary recommendations are presented based on the findings. These recommendations involve: i) modifying DBT to meet the needs of individuals diagnosed with BPD and comorbid conditions; ii) engaging direct-care staff in implementation of concurrent DBT treatment; iii) implementing weekly self-reflection and debriefing sessions for the treatment team; iv) utilizing therapists certified in DBT to train direct-care staff in DBT skill implementation; v) providing daily DBT support with diary cards and chain analysis; vi) focusing on mindfulness and distress tolerance skills; vii) using environmental cues like posters depicting DBT skills on the unit; viii) developing nurse working groups that focus on DBT policy and practice; and ix) collaborating with nurse researchers on qualitative studies that explore the lived experiences of patients receiving DBT treatment.



nursing practice, DBT, implementation, psychiatry, in patient