PurposeTo synthesise qualitative research on individuals diagnosed with (or reportedly showing traits of) borderline pattern personality disorder who underwent dialectical behaviour therapy, aiming to comprehend their perceptions of change processes and the therapy's effects.MethodA comprehensive literature search was conducted across multiple online databases and grey literature sources. Papers were quality appraised using an adapted version of the Critical Appraisal Skills Programme tool. A metaethnographic approach was employed during the synthesis.ResultsEleven studies met criteria for inclusion in the review. The main themes identified through the synthesis process were the impact of DBT, the supportive structure and the 1:1 therapy component.ConclusionsThe synthesis uncovered the importance of various processes within DBT that patients perceived as active ingredients for their change. Many of these processes aligned with proposed theoretical processes of change and quantitative research on DBT's effectiveness.