Assessment and treatment of personality disorders: A behavioral perspective.

Abstract

Personality disorders are complex and highly challenging to treatment providers; yet, for clients with these problems, there exist very few treatment options that have been supported by research. Given the lack of empirically-supported therapies for personality disorders, it can be difficult to make treatment decisions for this population. The purpose of this paper is to present our view that basic behavioral principles can be integrated into the assessment and treatment of personality disorders to maximize success with such challenging behavioral patterns. Following a review of well-established behavioral assessment and treatment options, we offer additional suggestions upon which to base treatment: (a) the identification of relevant response classes and (b) the use of functional analysis in personality disorder treatment. We conclude with application of the proposed strategies to the examples of borderline and avoidant personality disorders.

Possibilidades analítico-comportamentais para a análise e investigação dos Transtornos de Personalidade

“…Tais estudos são a base interpretativa para que o analista do comportamento possa extrair a análise das contingências em operação nas situações de aplicação (Malavazzi, 2018). Estudos interessados nos transtornos de personalidade ainda são escassos na literatura analítico-comportamental, no entanto, os estudos que investigaram as classes de respostas comuns aos transtornos (Nelson-Gray et al, 2009) lançam luz e são de grande auxílio na compreensão do ambiente selecionador e nas possibilidades de intervenção.…”

“…Compreender a personalidade de uma perspectiva selecionista afeta diretamente nosso modo de analisar e investigar transtornos. Obras recentes da literatura analítico--comportamental apresentaram possibilidades de análise do fenômeno (Nelson-Gray et al, 2009).…”

Functional Analytic Psychotherapy (FAP) for cluster B personality disorders: Creating meaning, mattering, and skills.

“…Functional Analytic Psychotherapy, FAP (Tsai et al, 2009), is a contextual cognitive behavior therapy with roots in radical behaviorism. Briefly stated, FAP is a behavioral treatment that utilizes the therapeutic relationship to improve interpersonal difficulties (Nelson-Gray et al, 2009). FAP therapists endeavor to create vital, organic, meaningful, and dynamic therapeutic alliances (for an interpretation of FAP therapeutic alliance see Tsai et al, 2010) that progress and expand based on the therapist's conceptualization of the client's in-session behaviors, or clinically relevant behaviors (known in FAP terminology as “CRBs”).…”

“…(Due to space limitations please see Callaghan, 1998, for further discussion of these classes). Given the complexity and salience of CRBs in the cluster B client, FAP may be of assistance with this population as it has been hypothesized that identification of problematic response classes and the use of functional analysis techniques are likely to maximize success with this challenging population (Nelson-Gray et al, 2009).…”

“…Functional Analytic Psychotherapy (Tsai, Kohlenberg, Kanter, Kohlenberg, Follette, & Callaghan, 2009) is a contextual cognitive behavioral therapy that focuses on the importance of developing effective interpersonal skills via the therapeutic relationship, and posits that contingent responding by the therapist to in vivo client problems and improvements provides the mechanism for change in psychotherapy (Tsai, Kohlenberg, & Kanter, 2010). Although termination and poor reported outcomes are problems of particular importance and impact in working with clients with an Axis II diagnosis (Hilsenroth, Holdwick, Castlebury, & Blais, 1998), there is evidence that behaviorally-oriented techniques can improve clinical practice with regard to personality disorders (Nelson-Gray, Lootens, Mitchell, Robertson, Hundt, & Kimbrel, (2009). This article is a brief summary discussion around the application of Functional Analytic Psychotherapy in the treatment of cluster B Personality Disorders.…”