Therapy for Clients with Personality Disorder

DSM-5-TR Diagnostic Criteria

According to DSM-5-TR criteria, people must exhibit symptoms like impulsivity, an unstable self-image, a fear of abandonment, impulsivity, interpersonal relationship issues, quick mood swings, impulsive behavior, a pattern of repeated suicidal behavior, persistent feelings of emptiness, dissociative episodes, and problems with anger management to be diagnosed with borderline personality disorder (BPD) (Videler, 2019). First individuals should have a history of both previous and present suicidal thoughts and actions. Individuals also experience emotional instability brought on by everyday events (such as strong episodes of melancholy, irritation, or worry that endure only sometimes for a few days). They are frantically trying to prevent actual or imagined abandonment. Some patients act impulsively and have several partners for sexual activity. They also struggle with identification, especially with dissociation episodes and a confused perception of who they are.

Therapeutic Approach and a Modality

A therapeutic method I might employ is Dialectical Behavior Therapy. Dialectical Behavior Therapy (DBT) is the most effective handling BPD symptoms. DBT was developed specifically to support BPD patients in identifying and managing their symptoms. DBT focuses on the client’s behaviors in the present rather than their prior habits. Its four components are emotional regulation, mindfulness, interpersonal effectiveness, and pain tolerance (Perrotta, 2020). Patients will be able to concentrate on their current state, comprehend their behaviors and feelings, refrain from passing judgment on their present emotions, and employ useful coping mechanisms in difficult circumstances with the assistance of these factors.

A modality I would choose for treating BPD is self-help techniques. Any BPD treatment program must include self-help techniques (Perrotta, 2020). These should, of course, not be used in place of professional therapy; rather, they should be used as a supplement. The best course of action is to discover more about the condition using self-help education, acquiring effective coping mechanisms for BPD, and identifying techniques to help individuals explore and regulate their motions. BPD sufferers have access to helpful self-help materials that may be used in addition to more conventional types of treatment. Books and internet resources provide details on BPD as well as advice on how to deal with its symptoms.

Therapeutic Relationship

A client (or patient) and a psychiatrist are said to have a therapeutic relationship, which is occasionally known as a therapeutic partnership, helpful alliance, or professional alliance (Bozzatello et al., 2019). It an effective method for a psychotherapist and a patient to relate and support the patient change for the better. It is an ongoing interaction with the patient and families that is considerate, unambiguous, constrained, encouraging, and expert.

In order to win the client’s trust and develop a rapport before making a diagnosis, remember that the therapeutic relationship is more “intimate” and deeper than a standard doctor-patient one (Bozzatello et al., 2019). From the outset, it’s critical to build and preserve an honest and trustworthy relationship with the client. I may take the time to clarify the diagnosis and the therapeutic process to them and involve them in it so they accept responsibility for their triumphs and mistakes and work toward their objectives both during and after therapy. I will go into detail about how clinical manifestations are just regular human psychological and emotional experiences that have recently intensified, gotten worse, or become exacerbated.

The ways a diagnosis is shared with an individual, a family, and in a group session differ significantly. In order to communicate information with a specific client, I will meet with him in person and use the clearest language possible to explain his diagnosis, course of treatment, and potential symptoms. When sharing with the family, I will gather entire family in one location and explain to them why it is important for them to comprehend the diagnosis as well as the reason for the meeting. Confidentiality must always be upheld in group therapy (Bozzatello et al., 2019). I will discuss the disorder, cause, and practical solutions without mentioning the clients’ names or any other sensitive information.

References

Bozzatello, P., Bellino, S., Bosia, M., & Rocca, P. (2019). Early detection and outcome in borderline personality disorder. Frontiers in psychiatry, 10, 710. https://doi.org/10.3389/fpsyt.2019.00710

Perrotta, G. (2020). Borderline Personality Disorder: definition, differential diagnosis, clinical contexts and therapeutic approaches. Ann Psychiatry Treatm, 4(1), 043-056. https://orcid.org/0000-0003-0229-5562

Videler, A. C., Hutsebaut, J., Schulkens, J. E., Sobczak, S., & Van Alphen, S. P. (2019). A life span perspective on borderline personality disorder. Current psychiatry reports, 21, 1-8. https://doi.org/10.1007/s11920-019-1040-1