Therapy for Clients with Personality Disorders

Review this week’s Learning Resources and reflect on the insights they provide about treating clients with personality disorders.
Select one of the personality disorders from the DSM-5 (e.g., paranoid, antisocial, narcissistic). Then, select a therapy modality (individual, family, or group) that you might use to treat a client with the disorder you selected.

The Assignment:

Succinctly, in 1–2 pages, address the following:

Briefly describe the personality disorder you selected, including the DSM-5 diagnostic criteria.
Explain a therapeutic approach and a modality you might use to treat a client presenting with this disorder. Explain why you selected the approach and modality, justifying their appropriateness.
Next, briefly explain what a therapeutic relationship is in psychiatry. Explain how you would share your diagnosis of this disorder with the client in order to avoid damaging the therapeutic relationship. Compare the differences in how you would share your diagnosis with an individual, a family, and in a group session.

Support your response with specific examples from this week’s Learning Resources and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources. 3 peer reviewed references

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Therapy for Clients with Personality Disorders

Antisocial Personality Disorder

Antisocial personality disorder is a mental disorder characterized by a persistent lack of regard for right and wrong and ignoring the rights and feelings of other people (Münch, Walter & Müller, 2020). According to the DSM-diagnostic criteria, symptoms of antisocial personality disorder include disregarding right and wrong, persistently lying to exploit other people, callousness, manipulating other people for personal gain, sense of superiority, problems with the law, impulsiveness, irritability, violence, lack of empathy or remorse, inability to maintain relationships, irresponsibility and unnecessary risk-taking (Münch, Walter & Müller, 2020). Individuals with antisocial personality disorder normally exhibit these symptoms before the age of 15 years (Münch, Walter & Müller, 2020).

Therapeutic Approach

Cognitive-behavioral therapy (CBT) is the treatment approach that can be used to treat antisocial personality disorder. The reason for choosing CBT is because, from a cognitive-behavioral perspective, personality disorders such as antisocial personality disorder are maintained by maladaptive and negative beliefs about self and others and environmental/contextual factors that destabilize effective behaviors and lack of skills to facilitate adaptive and positive responding (Sargın, Özdel & Türkçapar, 2017). CBT integrates various techniques to modify maladaptive beliefs and environmental/contextual factors through behavior modification, cognitive restructuring, psychoeducation, and skills training. Additionally, CBT alters the maladaptive thinking patterns and as a result, individuals are able to adopt a positive thinking pattern; as a result, a person adopts an adaptive thinking pattern, which changes feelings, mood and behavior (Sargın, Özdel & Türkçapar, 2017). Additionally, CBT in people with antisocial personality disorder supports collaborative, supportive, and well-defined therapeutic relationship in order to help the client’s motivation and determination to make changes and also acts as a potent energy source (Sargın, Özdel & Türkçapar, 2017). Therefore, CBT is effective in addressing the diffuse and pervasive impairments commonly present in patients with an antisocial personality disorder.

Therapeutic Relationship

A therapeutic relationship in psychiatry refers to the relationship between the therapist and the therapist. A therapeutic relationship focuses on the experiences, ideas, and feelings of the client and the client and therapist engage with each other to identify areas that need focus and evaluate the level of change in the client (Hartley, Raphael, Lovell & Berry, 2020). A good therapeutic relationship helps a client to open up and motivates the client to adhere to the treatment plan to improve the treatment outcomes.

In order to maintain the therapeutic relationship, it would be important to share the diagnosis in an empathic and respectful manner (Moudatsou et al., 2020). The client should be provided with all the information about the diagnosis, including the prognosis and the available therapeutic options. The therapist should ensure that all the patient’s concerns are addressed while respecting the professional boundaries. During a group or family therapy session, it would be important to seek permission from the client before disclosing the diagnosis. If the patient does not consent to the diagnosis to be shared in front of the family members and group members, the decision should be respected. This is to ensure that the confidentiality and privacy of the client’s information are respected and protected.

References

Hartley, S., Raphael, J., Lovell, K., & Berry, K. (2020). Effective nurse-patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. International journal of nursing studies, 102, 103490. https://doi.org/10.1016/j.ijnurstu.2019.103490

Retrived on 5 January 2022 from <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026691/>

Moudatsou, M., Stavropoulou, A., Philalithis, A., & Koukouli, S. (2020). The Role of Empathy in Health and Social Care Professionals. Healthcare (Basel, Switzerland), 8(1), 26. Retrived on 5 January 2022 from <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151200/>

Münch, R., Walter, H., & Müller, S. (2020). Should behavior harmful to others be a sufficient criterion of mental disorders? Conceptual problems of the diagnoses of antisocial personality disorder and pedophilic disorder. Frontiers in psychiatry, 11, 954.

Retrieved on 5 January 2022 from <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523554/>

Sargın, A. E., Özdel, K., & Türkçapar, M. H. (2017). Cognitive-Behavioral Theory and Treatment of Antisocial Personality Disorder. Psychopathy-New Updates on an Old Phenomenon. Retrieved on 5 Jnauary from <https://www.intechopen.com/chapters/55712>