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- 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.
Psychotherapy With Personality Disorders
College of Nursing-PMHNP, Walden University
NRNP 6645: Psychotherapy with Multiple Modalities
August 08, 2021
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Psychotherapy With Personality Disorders
Individuals with personality disorders frequently have difficulty conquering continuing
patterns of thinking and behavior experienced in daily life. when patients are mindful that
personality-related issues are initiating substantial suffering and are approachable to therapy,
treatment can still be difficult for both the patient and the therapist. The purpose of this paper is
to review borderline personality disorder and psychotherapeutic management.
A borderline personality disorder is a pattern of instability in interpersonal 301.83 (F60.3)
is defined as a persistent display of unstable relationships, issues with self-image, increased
impulsive behaviors, and five or more of the following symptoms (APA, 2013).
Hysterical struggles to avoid abandonment. Unbalanced and extreme relationships are
portrayed by varying extremes of fantasy and depreciation. Identity disturbance: markedly and
persistently unstable self-image or sense of self. Impulsive behaviors in two areas of life that can
be detrimental harmful including overspending, Unsafe sexual behavior, gambling, substance
abuse, self-harm, and reckless behaviors. Self-harm and suicidal threat/attempt behaviors. Severe
incidences of nervousness, irritability, or dysphoria lasting hours to few days. Persistent thoughts
of emptiness. Numerous presentations of anger and temper. Brief bouts of paranoia or
dissociative symptoms (APA, 2013).
Dialectical behavioral therapy (DBT) encourages stability of acceptance and change by
using validation and problem-solving approaches and recognizing reality exactly as it is. DBT
believes in three stages of obligation throughout the program. The three stages include specific
treatments that target barriers, concentrating on the course plan, and commitment to contribute
throughout the specific timeframe toward eradicating self-harm behaviors and improving optimal
health (Gold, 2021). DBT continues to lead as an evidence-based method for treatment in
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borderline personality disorder. DBT is a variation of cognitive-behavioral therapy (CBT), mixed
with mindfulness and radical acceptance. According to research in one study DBT decreased
overdoses and consequent hospitalizations. According to research, a meta-analysis maintains
that DBT is a successful and specialized approach to treating affected with a borderline
personality disorder (Gold, 2021). There is a significant amount of research that a therapeutic
relationship is the groundwork to therapy and an essential need. Research has suggested that one
fundamental facet of a therapeutic relationship includes the shared and collaborative with both
therapist and patient to equally agree on objectives. There are factors that may impede the
relationship between the patient, therapist, or environment. Positive therapeutic relationships
according to the literature highlight the significance of better outcomes. Poor therapeutic
relationships relate to unhealthy consequences including and even leading to an escalation in
violence. It is critical to be aware of and understand the importance of building and maintaining
a stable therapeutic relationship as well as increasing recommendations in practice(Bolsinger et
al., 2020). Individual therapy, skills groups, consults between providers and therapists, and
environment structure are elements of DBT. The idea of the therapeutic relationship, which is
recognized as the foundation of change in therapy. Partnership built amid the provider and client
permits them to vacillate between acceptance and change (Keller et al., 2017). In order to share a
diagnosis, I would first ask questions pertaining to the DSM criteria. I would provide the
epidemiology of the illness, provide psychoeducation, support as well as recommending support
resources. It is necessary to conduct the conversation that is both client centered and sensitive.
Connecting to the clients indicated goals and beliefs offers important support and assists in
establishing treatment steering to optimal outcomes (Austin & Butler, 2017).
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According to studies, there is substantial effect of BPD of patients’ families’ physical and
mental health. According to a study, providing psychoeducation and family therapy improves
emotional changes, conflict resolution as well as reducing distress (Jaber et al., 2021).
Group therapy is beneficial as it decreases isolation, provides mutual support, introduces
positive standards, and chances to create alternative methods by relating with peers. Group
therapy provides an environment to learn cohesiveness and collaboration. A critical issue for
members of the group to remain in therapy (Keller et al., 2017).
In conclusion, it is important for the provider to work with clients by providing patience,
support, education, and resources to encourage DBT. Establishing a therapeutic relationship with
clients is essentail to promote individual, family and group therapy options on what is in the
clients’ needs. Promoting psychoeducation and therapies and therapeutic relationships will
promote optimal health for the client and clients’ family. The journals and resources used in
this paper are scholarly and credible as they are less than five years old and found in the Walden
Library.
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References
APA. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). [MBS Direct].
Retrieved from https://mbsdirect.vitalsource.com/#/books/9780890425572/
Austin, S., & Butler, S. (2017). Disclosing & discussing “difficult” mental health diagnoses.
Society for the advancement of psychotherapy.
https://societyforpsychotherapy.org/disclosing-discussing-difficult-mental-health-
diagnoses/
Bolsinger, J., Jaeger, M., Hoff, P., & Theodoridou, A. (2020). Challenges and opportunities in
building and maintaining a good therapeutic relationship in acute psychiatric settings: A
narrative review. Frontiers in Psychiatry, 10.
https://doi.org/ezp.waldenulibrary.org/10.3389/fpsyt.2019.00965
Gold, A. L. (2021). Building commitment to change: Lessons from DBT. Brown University
Child & Adolescent Behavior Letter, 37(3), 1–4.
https://doi.org/ezp.waldenulibrary.org/10.1002/cbl.30526
Jaber, A., David, P., Berube, F. A., Perusse, F., Busque, H., Noiseux-Lescop, N., & Cailhol, L.
(2021). Évaluation d’une Thérapie comportementale dialectique auprès de proches de
personnes considérées atteintes du trouble de la personnalité limite. L’Évolution
Psychiatrique, 86(1), 67–76.
https://doi.org/ezp.waldenulibrary.org/10.1016/j.evopsy.2020.11.004
Keller, S., Page, D., de Roten, Y., Despland, J. N., Caspar, F., & Kramer, U. (2017). Adaptation
of the Motive-Oriented Therapeutic Relationship Scale to group setting in dialectical-
behaviour therapy for borderline personality disorder. Journal of Psychotherapy
Integration, 27(1), 47–58. https://doi.org/org.ezp.waldenulibrary.org/10.1037/int0000061
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