Relationship management therapy allows patients to choose their own treatment. The model requires that patients who engage in or threaten self-harm or aggressive behavior are discharged from the inpatient part of the program for 24 hours. This study compared mean annual outcome rates for the 27 patients who were consecutively enrolled in the relationship management therapy program from 1998 to 2000. Significant reductions were found in restraint, constant nursing observation, self-harm incidents, and inpatient days. These results fill a gap in the literature about a treatment model that one day could be considered a best practice.