Personality Disorders Flashcards
Borderline Personality Disorder is characterized by what?
Unstable relationships; poor self-image; lack of emotional regulation
Considerations for Borderline Personality Disorder are?
- Create a strong therapeutic alliance
- Monitor personal reactions; be compassionate; process transference
- Collaborate with professionals as appropriate
- Be firm, consistent, and reliable; set boundaries; take an active approach
- Address suicidal and self-destructive behaviors
- Establish a detailed treatment plan
- Assess for comorbidity and trauma
Treatments for BDP include
Dialectical Behavior Therapy (DBT), Schema Therapy (ST), Psychodynamic, Cognitive Analytic Therapy (CAT), STEPPS group therapy
SSRIs and Antipsychotic medication for BDP are used to treat what?
Specific Symptoms- not the disorder itself
DBT is effective to reduce what in BPD?
Self-injurious and suicidal symptoms
What does DBT teach clients with BPD?
Adaptatively cope with emotions
What treatment for BPD explores schemas formed early in life and attempts to modify maladaptive representations of these relationships?
Schema Therapy
What does psychodynamic treatment do when treating clients with BPD?
Postulates relational problems are carried from childhood into adulthood; thus, the goal is to develop stable sense of self and relationships
What is Mentalization-based psychotherapy based on?
Attachment Theory
What is Transference-Focused Psychotherapy?
Manualized treatment that
focuses on object relations theory
Psychodynamic treatment is used to put emphasis on what in regards to BPD?
Personality Development
Explain Cognitive Analytic Therapy (CAT)
Brief collaborative therapy based on cognitive therapy, elements of cognitive
psychology and psychodynamic psychotherapy
Which Personality Disorder is characterized by blatant disregard and violation of the rights of others?
Antisocial Personality Disorder (ASPD)
Counselor Considerations for Antisocial Personality Disorder include:
- Utilize external motivations to facilitate the change process, as well as motivational interviewing and enhancement techniques
- Establish a supportive, yet structured approach to treatment
- Seek appropriate consultation and supervision
- Fully assess antisocial behaviors, personality function, possible comorbid mental disorders, and treatment needs
ASPD treatment includes:
Schema Therapy, Mentalization-Based Therapy (MBT), and CBT
Medications for clients with ASPD are used to treat secondary symptoms such as
anxiety, depression, impulsivity, irritability
What is the goal of schema therapy with ASPD clients?
To heal maladaptive schema and enhance adaptive coping styles
Techniques for Schema Therapy include:
re-scripting, chair work, journaling, and flash cards
Mentalization-Based therapy for ASPD clients aims to do what?
Increase mentalization ability (recognition of connection between thoughts, feelings, and desires with behaviors and interactions)
Which disorder is characterized by excessive admiration; overvaluation of
others’ opinions and reactions?
Narcissistic Personality Disorder
Counselor considerations for Narcissistic Personality Disorder are:
• Those with NPD can be very manipulative, guarded, hypervigilant, and easily provoked when they perceive the
fidelity of their fragile ego is at stake
• It is necessary to identity narcissistic wounds, recognize the role they play in functioning, and actively work on changing these behaviors and reactions
• Build a strong therapeutic alliance
• A strong here-and-now focus is helpful
• Assess for co-occurring disorders
Treatments for NPD include:
Psychodynamic, CBT, Schema-Focused Therapy (ST), and Metacognitive Interpersonal Therapy (MIT)
Which treatment for NPD works to decrease unconscious fears of vulnerability and build confidence to decrease sensitivity to feedback from others and reduce hostility toward others, increase empathy, validate others, identify triggers, gain insight into patterns of thinking and behavior, construct realistic standards?
Metacognitive Interpersonal Therapy
Which personality disorder is characterized by attention seeking; self-dramatization?
Histrionic Personality Disorder
Counselor Considerations for Histrionic Personality Disorder include:
- Clients typically seek counseling due to comorbid disorders or secondary to feelings of hurt or rejection
- Many of the symptoms of HPD are culturally dependent
- Care should be taken not to appear critical; create a therapeutic climate
- Set firm boundaries and engage in self-reflection
- Consider co-morbid disorders
- Mention of suicide should not be minimized
Treatments for Histrionic Personality Disorder includes:
Functional Analytic Psychotherapy (FAP), Cognitive Analytic Therapy (CAT), and CBT
Which personality disorder is characterized by inflexibility; perfectionism; and the valuing of order and rules
Obsessive-Compulsive Personality Disorder (OCPD)
Counselor Considerations for Obsessive-Compulsive Personality Disorder include:
• Formation of a therapeutic relationship is challenging and may take a considerable amount of time due to client
discomfort
• Avoid engaging in a power struggle
• Treatment should be realistic and take into account the discomfort and anxiety client experience in situations of
change, uncertainty, and emotional vulnerability
• Be aware of comorbid disorders
Treatments for Obsessive-Compulsive Personality Disorder include:
CBT and DBT
Which personality disorder is characterized by being inhibited; feelings of inferiority?
Avoidant Personality Disorder (AVPD)
Counselor Considerations for Avoidant Personality Disorder include:
• Recognize that clients with AVPD have pervasive pathology involving interpersonal insecurity and low self-esteem
• Convery availability, empathy, acceptance, and support, and build on
the clients’ strengths
• Consistently evaluate own levels of countertransference
• Assess the potential role of cultural factors
• This population may require career counseling or access to vocational services
Treatments for Avoidant Personality Disorder include:
Behavioral Therapy, CBT and Schema Therapy
Which personality disorder is characterized by enmeshment; the desire/requirement of external guidance and support from others?
Dependent Personality Disorder
Counselor Considerations for Dependent Personality Disorder include:
• Those with DPD often seek treatment after the loss of an attachment figure, or secondary to the request of another
• With a therapeutic alliance in place, counselors can encourage clients
to begin enhancing their own independence
• Unique clinical challenges: requesting counselor advise, placing the counselor in a dominant decision-maker role, making changes outside treatment to maintain attachment with the counselor, sharing stories of mistreatment, and avoidance of dealing with separation issues
• Consider comorbid disorders, conduct a thorough assessment, and assess cultural factors
Treatment for Dependent Personality Disorder include:
Psychodynamic Approaches, Schema Therapy and CBT
Which personality disorder is characterized by interpersonal deficits; odd, eccentric behaviors; perceptual disturbances
Schizotypal Personality Disorder (STPD)
Counselor Considerations for Schizotypal Personality Disorder includes:
- Population rarely seeks treatment; thus, counselors are challenged to engage them and must built trust, create a safe environment, and develop a strong connection with them
- Counselors need to be prepared to manage discomfort with clients’ strange, odd, and eccentric reactions, ideas, and behaviors; nonjudgement is important
- Too much personal exploration should be avoided due to clients’ tendency to decompensate
- Assess for common disorder that co-occur
Treatment for Schizotypal Personality Disorder include:
Psychoeducation, CBT, Case management, and Psychopharmacotherapy
What is the most effective approach to treating those with Schizotypal Personality Disorder?
A combination of psychotropic medication and psychosocial therapies
Which personality disorder is characterized by inability and lack of desire to form social relationships
Schizoid Personality Disorder
Counselor Considerations for Schizoid Personality Disorder inclundes
• Therapeutic trust is one of the most essential characteristics needed
in treatment
• External motivations for seeking counseling should be utilized and
fully explored
• Areas to be assessed: interpersonal functioning, eccentric behaviors,
social aversion and withdrawal, personality function, and any
common comorbid mental disorders
• Determine cultural and situational factors that may better account for
clients’ behaviors
Treatment for Schizoid Personality Disorder include:
Behavior Therapy and CBT
Which personality disorder is characterized by suspiciousness; a general mistrust of others
Paranoid Personality Disorder
Counselor Considerations for Paranoid Personality Disorder includes:
• Those with PPD do not typically seek counseling due to being prone to
externalizing and lack of insight
• Consider client’s cultural background prior to diagnosis
• Provide clients with control over session frequency, encourage them to be active in developing counseling goals and tasks, and allow them to determine the focus of sessions
• Be mindful of personal reactions; avoid being overly effusive
• Differentiate between PPD and other disorder that appear similar and assess
for comorbid personality disorder diagnoses
Treatments for Paranoid Personality Disorder include:
Behavior Therapy, CBT, and Medication to treat anxiety and depressive symptoms while antipsychotic may be useful in addressing paranoid ideation.
