For more than 20 years, patients with borderline personality disorder have been treated as in-patients in the UC St-Jozef in Kortenberg, Belgium. The majority of these patients were treated in a psychoanalytical or a behavior therapy ward. During these years, the treatment programs of these wards were gradually adjusted to the challenges provided by these patients. In this paper, we will describe the process of change that both wards have experienced. We will highlight similarities and differences between the approaches that are the result of an evolution over years. In both approaches, there is a strong emphasis on training and support for staff. While the psychoanalytical ward uses a group approach, the behavior therapy ward evolves towards a more individualized treatment.