Individuals with personality disorders often find it difficult to overcome the enduring patterns of thought and behavior that they have thus far experienced and functioned with in daily life. Even when patients are aware that personality-related issues are causing significant distress and functional impairment and are open to counseling, treatment can be challenging for both the patient and the therapist. For this Assignment, you examine specific personality disorders and consider therapeutic approaches you might use with clients.
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-TR (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.
Succinctly, in 1–2 pages, address the following:
Briefly describe the personality disorder you selected, including the DSM-5-TR 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.
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The personality disorder, narcissistic personality disorder (NPD) for this assignment. According to the DSM-5-TR, NPD is characterized by a pervasive pattern of grandiosity, need for admiration, and lack of empathy, beginning in early adulthood and present in a variety of contexts. The individual must have at least five of the following criteria:
Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people or institutions
Requires excessive admiration
Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
Is often envious of others or believes others are envious of him or her
Shows arrogant, haughty behaviors or attitudes
For the treatment of NPD, I would use cognitive-behavioral therapy (CBT) as my therapeutic approach, and individual therapy as my modality. According to the research, CBT has been found to be effective in reducing narcissistic traits and improving interpersonal functioning. In CBT, the therapist helps the client to identify and challenge their maladaptive thoughts and beliefs, and to develop more realistic and healthy ways of thinking. This is appropriate for NPD because the individual with NPD typically has grandiose beliefs about themselves, which can be challenged and modified through CBT. Additionally, individual therapy allows for a tailored approach to the client’s specific needs, which is important in addressing the complex and ingrained patterns of thought and behavior in NPD.
A therapeutic relationship in psychiatry is the connection that is formed between the therapist and the client. In order to avoid damaging the therapeutic relationship, the therapist should explain the diagnosis in a way that is clear, empathetic, and respectful. In an individual session, I would share the diagnosis of NPD by explaining what the disorder is, how it can affect a person’s life, and how it is diagnosed. I would also explain that the diagnosis is not a reflection of the person’s worth as a human being, but rather a label for a pattern of thoughts, feelings, and behaviors. I would also encourage the client to ask any questions they may have, and provide reassurance that they are not alone in their experience.
In a family session, the diagnosis would be shared with the family members present, and the focus would be on how the disorder affects the family dynamics, and how the family can support the individual in treatment. I would also explain the importance of maintaining boundaries and not enabling the person’s maladaptive behavior.
In a group session, the diagnosis would be shared with the group members, and the focus would be on providing support, validation, and encouragement for each other. The group would also provide an opportunity for the individual to learn from others who have similar experiences and to gain insight into their own behavior.
References:
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision (DSM-5-TR).
Campbell, W. K., & Miller, J. D. (2011). The handbook of narcissism and narcissistic personality disorder:
