Principles for psychosocial treatment of personality disorder: Summary of the APA Division 12 Task Force/NASPR review

Abstract

A wide variety of clinical problems and relational styles are collected under the diagnostic heading of personality disorder (PD). These disorders involve maladaptive, persistent ways of thinking, feeling, and behaving that are associated with both functional impairment and disturbed interpersonal relationships. Personality disorders are difficult to treat, and challenge a therapist's ability to intervene helpfully, in part because the maladaptive patterns can impact the therapy relationship itself. Therapeutic principles were derived by Task Force review from the small body of research conducted to date with this family of disorders and include characteristics of clients and therapists, their relationship together, and essential elements of technique. The importance of a collaborative relationship as well as a treatment that is comprehensive, empathic, patiently applied, and flexibly tailored to presenting problems are dominant themes across principles. Treatment research with PD is in its early stages and many important areas remain uncharted. The Task Force principles are here summarized in hopes of providing general guidance to clinicians working with PD, as well as to outline research needs for the area.

The Practice of Functional Analytic Psychotherapy

“…This may include subpopulations of depressed clients with co-morbid personality disorders or relationship discord. Regarding the treatment of personality disorders, the American Psychological Association Task Force recently released guidelines that call specifically for treatments that include the therapeutic relationship as a mechanism of behavior change (Critchfield & Benjamin, 2006), which supports our contention that FAP would be an important addition to BA in this situation.…”

Organization of co‐occurring Axis II features in borderline personality disorder

“…An acceptable level of reliability for BPD categorical diagnosis was also obtained (κ=0.64). A high base‐rate of BPD was noted for our referrals and helps ensure that the sample contains valid BPD diagnoses (Critchfield, Levy, & Clarkin, 2007).…”

Personality Disorders among Danish Alcoholics Attending Outpatient Treatment

“…At present, we do not know which type of therapy is best to treat PD [25] . Only a few studies deal with the treatment of antisocial PD and highly structured treatment programme during hospitalization is recommended for these cases [26,27] , while dialectical behaviour therapy is recommended for the treatment of borderline PD [25] . The treatment of the other PDs has not been studied and randomized controlled studies in this field are definitely needed.…”