Psychotherapy With Personality Disorders

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


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APA. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). [MBS Direct].

Retrieved from

Austin, S., & Butler, S. (2017). Disclosing & discussing “difficult” mental health diagnoses.

Society for the advancement of psychotherapy.


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.

Gold, A. L. (2021). Building commitment to change: Lessons from DBT. Brown University

Child & Adolescent Behavior Letter, 37(3), 1–4.

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.

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.

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