Where I am getting my treatment for my BPD

Dialectical Behavior Therapy program to open
at McLean
(June 2007 Issue)


By Jennifer Chase Esposito

This month, McLean Hospital in Belmont, Mass., will open what's believed to be one of the first residential treatment facilities in the country for treating adolescent girls in need of intense psychiatric care using Dialectical Behavior Therapy (DBT).

Originally developed to treat adult suicidality resulting from Borderline Personality Disorder, researchers have found positive effects using DBT treatments with adolescents. The patient population will be females aged 13-19 suffering from consistent emotional dysregulation who have not responded to previous treatments.

"Dialectical Behavior Therapy first looks at emerging Borderline Personality Disorder as a diagnosis [that] is restricted to adults, so no such therapy is [typically] done on children," says Philip Levendusky, Ph.D., vice president of network development at McLean.

Levendusky says there is "clear evidence that kids have the same profile as adults," but because the symptoms are seen so early in their lives and can often be confused with the normal maladies of adolescence, the symptoms may seem less apparent.

"What we've had here [at McLean] are generic programs. But with the evolution of the field, there is incredible interest in applying [DBT] to adolescents," says Levendusky, adding that the new facility will "creatively try to put together a state-of-the-art treatment program."

"Parents have called us and say there is nothing of its kind," says Blaise Aguirre, M.D., medical director of the new Adolescent Dialectical Behavior Therapy Center, as it will be named. Aguirre has been a child and adolescent staff psychiatrist for seven years at McLean and is a psychiatry instructor at the Harvard Medical School where he provides child adolescent training for residents. He says he "doesn't know of any other short-term residential unit in the country that's using a strict DBT model of treatment, where all of the clinicians are trained in DBT treatment." Aguirre does say, however, there are clinicians practicing DBT on young people in San Francisco, Los Angeles, Seattle, and New York.

Although the program will be primarily for New Englanders, Aguirre doesn't rule out fielding inquiries from other parts of the United States. Current McLean patients come from all over this country and as far as Mongolia and Spain.

The average inpatient stay will be about four to six weeks. "Anecdotally, 70-80 percent [of patients] have really good outcomes when the DBT treatment is very intensive," says Aguirre. "It's the idea of really 'packing it in,' and immersing" patients in the program.

The other upshot of an intense stay at the center is that it will decrease the opportunity for relapse once the patient gets back into his/her normal routine. "The downside of DBT treatment [in adolescents] is that it's very difficult to have continuum of care when we discharge kids who can't get DBT in their home environment."

Aguirre says that almost all studies show that up to two percent of the general population suffers from BPD. "In adults, I've never seen - and I've asked very senior colleagues about this - a BPD person who didn't suffer in adolescence.

"If two percent of the population is suffering, that means a lot of adults are suffering," he says.

By developing programs that can quickly halt early symptoms of BPD from becoming full-blown BPD, Aguirre believes that McLean's new center will help.

This self-pay program will cost approximately $1,400 per day. For more information about the program call 877-967-7233.


It truly is one of the best hospitals in the entire country for this issue and I will always continue to work to get better.