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The Investigation of Behavioral Contracting in Patients with Borderline Personality Disorder

Kaiser Permanente, 2081 Palos Verde Dr., Lomita, CA 90717.

Lenore Goldstein, RNC, MS

Hillside Hospital, A Division of Long Island Jewish Medical Center in Glen Oaks, New York.

Lisa Schacht-Levine, RN, MSN, CS

Great Neck South Mlf iddle School in Great Neck, New York.

In this article the authors discuss the patient with borderline personality disorder, milieu issues, and an alternative therapeutic approach: a contingency contract developed to manage self-mutilating behavior in a cost-effective manner. This contract was created as a quality improvement project on a locked unit to decrease self-destructive behavior in the patient with borderline personality disorder. The goal was to assist patients in developing more adaptive coping mechanisms, resulting in decreased self-destructive behaviors. Since implementation in February 1992, there has been an 84% decrease in self-destructive behavior in patients with borderline personality disorder in the population.

Journal of the American Psychiatric Nurses Association, Vol. 2, No. 3, 71-76 (1996)
DOI: 10.1177/107839039600200303


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