Discussion: Therapy for Clients With Personality Disorders

Discussion: Therapy for Clients With Personality Disorders

Discussion: Therapy for Clients With Personality Disorders
Clients with personality disorders often find it difficult to overcome their problems and function in daily life. Even when these clients are aware that they have a dysfunction with their personality and are open to counseling, treatment can be challenging for both the client and the therapist. For this Discussion, as you examine personality disorders, consider therapeutic approaches you might use with clients.
Learning Objectives
Students will:
Analyze therapeutic approaches to treating clients with personality disorders
To prepare:
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Review this week’s Learning Resources and reflect on the insights they provide.
Select one of the personality disorders from the DSM-5.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the \”Post to Discussion Question\” link and then select \”Create Thread\” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit! Discussion: Therapy for Clients With Personality Disorders
By Day 3
Post a description of the personality disorder you selected. Explain a therapeutic approach (including psychotropic medications if appropriate) you might use to treat a client presenting with this disorder, including how you would share your diagnosis of this disorder to the client in order to avoid damaging the therapeutic relationship. Support your approach with evidence-based literature.
Read a selection of your colleagues\’ responses.
Learning Resources
Required Readings
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
Chapter 20, “Termination and Outcome Evaluation” (Review pp. 693–712)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: You will access this text from the Walden Library databases. Discussion: Therapy for Clients With Personality Disorders
Dixon-Gordon, K. L., Turner, B. J., & Chapman, A. L. (2011). Psychotherapy for personality disorders. International Review of Psychiatry, 23(3), 282–302. doi:10.3109/09540261.2011.586992
Note: You will access this text from the Walden Library databases.
Lorentzen, S., Ruud, T., Fjeldstad, A., & Høglend, P. A. (2015). Personality disorder moderates outcome in short- and long-term group analytic psychotherapy: A randomized clinical trial. British Journal of Clinical Psychology, 54(2), 129–146. doi:10.1111/bjc.12065
Note: You will access this text from the Walden Library databases.
Paris, J. (2004). Personality disorders over time: Implications for psychotherapy. American Journal of Psychotherapy, 58(4), 420–429. PMID: 15807086
Note: You will access this text from the Walden Library databases.
Swift, J. K., & Greenberg, R. P. (2015). What is premature termination, and why does it occur? In Premature termination in psychotherapy: Strategies for engaging clients and improving outcomes (pp. 11–31). Washington, DC: American Psychological Association. doi:10.1037/14469-002
Note: You will access this text from the Walden Library databases. Discussion: Therapy for Clients With Personality Disorders
Optional Resources
Dorr, D. (1999). Approaching psychotherapy of the personality disorders from the Millon perspective. Journal of Personality Assessment, 72(3), 407–425. PMID: 10491846
Bach, B., Lee, C., Mortensen, E. L., & Simonsen, E. (2016). How do DSM-5 personality traits align with schema therapy constructs? Journal of Personality Disorders, 30(4), 502–529. doi:10.1521/pedi_2015_29_212
Walden University. (2016). ASC success strategies: Studying for and taking a test . Retrieved from http://academicguides.waldenu.edu/ASCsuccess/ASCtesting
 
Introduction
A personality disorder refers to the mental disorder in which the person suffering from the same have a rigid and unhealthy pattern of thinking coupled with undesired functioning and behaving. People with personality disorder have difficulties perceiving and relating to situations and other people and thus, leading to limitations in relationships and social activities. In most cases, one would not know if he/she is having the personality disorder because the way of thinking and behaving appear natural to them. Even though there are several types of personality disorder; I chose to focus on schizotypal personality disorder (STPD) in this discussion.
Description of schizotypal personality disorder (STPD)
By description, schizotypal personality disorder (STPD) is a type of disorder characterized by the oddities of appearance, unusual perceptual experiences, behaviour, and speech, and anomalies of thinking which are similar as schizophrenia (Hazlett et al. 2015) . People having schizotypal PD usually fear social interaction because they think of others as being harmful.   Patients may also experience extreme anxiety in social situations. Some of the symptoms associated with a schizotypal personality disorder (STPD) include lack of close friends or confidants, being uncomfortable relating to people, anxious in social situations and superstitious. Patients with schizotypal personality disorder are often suspicious and may think others are out to hurt them (Jakobsen et al 2017). Discussion: Therapy for Clients With Personality Disorders
The therapeutic approach for schizotypal personality disorder (STPD)
When it comes to the therapeutic approach for schizotypal personality disorder (STPD), typical antipsychotic drugs and antidepressants would be prescribed for the patient. Atypical antipsychotics are prescribed to lessen anxiety and psychotic-like symptoms. Generally, patients with schizotypal personality disorders benefit from low-dose antipsychotic medications. These drugs act by reducing psychotic-like symptoms while improving day-to-day functioning.  Mainly, I will prescribe Clozapine. Clozapine works by reducing the negative symptoms associated with a schizotypal personality disorder (STPD). The advantage of using clozapine is that it has been shown to be effective treatment even for the patients who have failed to show positive response with the conventional antipsychotic (Argent & Hill, 2014). Nevertheless, clozapine has lower tolerability and therefore, need continuous blood monitoring
The second therapy is the Cognitive-behavioural therapy which focuses on helping the client acquire social skills and manage anxiety.  CBT will also be used to help the person understand how his/her thoughts and behaviours affect each other.  Thirdly, supportive psychotherapy can also be used. The central goal here is to establish an emotional, encouraging and supportive relationship with the patient (Jakobsen et al 2017).
In sharing the diagnosis of schizotypal personality disorder to the client to avoid damaging the therapeutic relationship, it is essential to be firm, consistent, and empathetic. I would first tell the patient before revealing the exact condition that his disorder is treatable. I will also tell the client the different treatment options that are available and then recommend the most appropriate one based on the symptoms. Discussion: Therapy for Clients With Personality Disorders
References
Argent, S. E., & Hill, S. A. (2014). The novel use of clozapine in an adolescent with borderline personality disorder. Therapeutic Advances in Psychopharmacology, 4, 4, 149-155.
Hazlett, E. A., Rothstein, E. G., Ferreira, R., Silverman, J. M., Siever, L. J., & Olincy, A. ( 2015). Sensory gating disturbances in the spectrum: Similarities and differences in schizotypal personality disorder and schizophrenia. Schizophrenia Research, 161, 283-290.
Jakobsen, K. D., Nielsen, J., Jakobsen, K. D., Skyum, E., Hashemi, N., Schjerning, O., Nielsen, J., … Jakobsen, K. D. ( 2017). Antipsychotic treatment of schizotypy and schizotypal personality disorder: A systematic review. Journal of Psychopharmacology, 31, 4, 397-405. Discussion: Therapy for Clients With Personality Disorders