Personality Disorders

Question 1

Borderline Personality Disorder is characterized by what?

Answer 1

Unstable relationships; poor self-image; lack of emotional regulation

Question 2

Considerations for Borderline Personality Disorder are?

Answer 2

• Create a strong therapeutic alliance
• Monitor personal reactions; be compassionate; process transference
• Collaborate with professionals as appropriate
• Be firm, consistent, and reliable; set boundaries; take an active approach
• Address suicidal and self-destructive behaviors
• Establish a detailed treatment plan
• Assess for comorbidity and trauma

Question 3

Treatments for BDP include

Answer 3

Dialectical Behavior Therapy (DBT), Schema Therapy (ST), Psychodynamic, Cognitive Analytic Therapy (CAT), STEPPS group therapy

Question 4

SSRIs and Antipsychotic medication for BDP are used to treat what?

Answer 4

Specific Symptoms- not the disorder itself

Question 5

DBT is effective to reduce what in BPD?

Answer 5

Self-injurious and suicidal symptoms

Question 6

What does DBT teach clients with BPD?

Answer 6

Adaptatively cope with emotions

Question 7

What treatment for BPD explores schemas formed early in life and attempts to modify maladaptive representations of these relationships?

Answer 7

Schema Therapy

Question 8

What does psychodynamic treatment do when treating clients with BPD?

Answer 8

Postulates relational problems are carried from childhood into adulthood; thus, the goal is to develop stable sense of self and relationships

Question 9

What is Mentalization-based psychotherapy based on?

Answer 9

Attachment Theory

Question 10

What is Transference-Focused Psychotherapy?

Answer 10

Manualized treatment that

focuses on object relations theory

Question 11

Psychodynamic treatment is used to put emphasis on what in regards to BPD?

Answer 11

Personality Development

Question 12

Explain Cognitive Analytic Therapy (CAT)

Answer 12

Brief collaborative therapy based on cognitive therapy, elements of cognitive
psychology and psychodynamic psychotherapy

Question 13

Which Personality Disorder is characterized by blatant disregard and violation of the rights of others?

Answer 13

Antisocial Personality Disorder (ASPD)

Question 14

Counselor Considerations for Antisocial Personality Disorder include:

Answer 14

• Utilize external motivations to facilitate the change process, as well as motivational interviewing and enhancement techniques
• Establish a supportive, yet structured approach to treatment
• Seek appropriate consultation and supervision
• Fully assess antisocial behaviors, personality function, possible comorbid mental disorders, and treatment needs

Question 15

ASPD treatment includes:

Answer 15

Schema Therapy, Mentalization-Based Therapy (MBT), and CBT

Question 16

Medications for clients with ASPD are used to treat secondary symptoms such as

Answer 16

anxiety, depression, impulsivity, irritability

Question 17

What is the goal of schema therapy with ASPD clients?

Answer 17

To heal maladaptive schema and enhance adaptive coping styles

Question 18

Techniques for Schema Therapy include:

Answer 18

re-scripting, chair work, journaling, and flash cards

Question 19

Mentalization-Based therapy for ASPD clients aims to do what?

Answer 19

Increase mentalization ability (recognition of connection between thoughts, feelings, and desires with behaviors and interactions)

Question 20

Which disorder is characterized by excessive admiration; overvaluation of
others’ opinions and reactions?

Answer 20

Narcissistic Personality Disorder

Question 21

Counselor considerations for Narcissistic Personality Disorder are:

Answer 21

• Those with NPD can be very manipulative, guarded, hypervigilant, and easily provoked when they perceive the
fidelity of their fragile ego is at stake
• It is necessary to identity narcissistic wounds, recognize the role they play in functioning, and actively work on changing these behaviors and reactions
• Build a strong therapeutic alliance
• A strong here-and-now focus is helpful
• Assess for co-occurring disorders

Question 22

Treatments for NPD include:

Answer 22

Psychodynamic, CBT, Schema-Focused Therapy (ST), and Metacognitive Interpersonal Therapy (MIT)

Question 23

Which treatment for NPD works to decrease unconscious fears of vulnerability and build confidence to decrease sensitivity to feedback from others and reduce hostility toward others, increase empathy, validate others, identify triggers, gain insight into patterns of thinking and behavior, construct realistic standards?

Answer 23

Metacognitive Interpersonal Therapy

Question 24

Which personality disorder is characterized by attention seeking; self-dramatization?

Answer 24

Histrionic Personality Disorder

Question 25

Counselor Considerations for Histrionic Personality Disorder include:

Answer 25

* Clients typically seek counseling due to comorbid disorders or secondary to feelings of hurt or rejection * Many of the symptoms of HPD are culturally dependent * Care should be taken not to appear critical; create a therapeutic climate * Set firm boundaries and engage in self-reflection * Consider co-morbid disorders * Mention of suicide should not be minimized

Question 26

Treatments for Histrionic Personality Disorder includes:

Answer 26

Functional Analytic Psychotherapy (FAP), Cognitive Analytic Therapy (CAT), and CBT

Question 27

Which personality disorder is characterized by inflexibility; perfectionism; and the valuing of order and rules

Answer 27

Obsessive-Compulsive Personality Disorder (OCPD)

Question 28

Counselor Considerations for Obsessive-Compulsive Personality Disorder include:

Answer 28

• Formation of a therapeutic relationship is challenging and may take a considerable amount of time due to client discomfort • Avoid engaging in a power struggle • Treatment should be realistic and take into account the discomfort and anxiety client experience in situations of change, uncertainty, and emotional vulnerability • Be aware of comorbid disorders

Question 29

Treatments for Obsessive-Compulsive Personality Disorder include:

Answer 29

CBT and DBT

Question 30

Which personality disorder is characterized by being inhibited; feelings of inferiority?

Answer 30

Avoidant Personality Disorder (AVPD)

Question 31

Counselor Considerations for Avoidant Personality Disorder include:

Answer 31

• Recognize that clients with AVPD have pervasive pathology involving interpersonal insecurity and low self-esteem • Convery availability, empathy, acceptance, and support, and build on the clients’ strengths • Consistently evaluate own levels of countertransference • Assess the potential role of cultural factors • This population may require career counseling or access to vocational services

Question 32

Treatments for Avoidant Personality Disorder include:

Answer 32

Behavioral Therapy, CBT and Schema Therapy

Question 33

Which personality disorder is characterized by enmeshment; the desire/requirement of external guidance and support from others?

Answer 33

Dependent Personality Disorder

Question 34

Counselor Considerations for Dependent Personality Disorder include:

Answer 34

• Those with DPD often seek treatment after the loss of an attachment figure, or secondary to the request of another • With a therapeutic alliance in place, counselors can encourage clients to begin enhancing their own independence • Unique clinical challenges: requesting counselor advise, placing the counselor in a dominant decision-maker role, making changes outside treatment to maintain attachment with the counselor, sharing stories of mistreatment, and avoidance of dealing with separation issues • Consider comorbid disorders, conduct a thorough assessment, and assess cultural factors

Question 35

Treatment for Dependent Personality Disorder include:

Answer 35

Psychodynamic Approaches, Schema Therapy and CBT

Question 36

Which personality disorder is characterized by interpersonal deficits; odd, eccentric behaviors; perceptual disturbances

Answer 36

Schizotypal Personality Disorder (STPD)

Question 37

Counselor Considerations for Schizotypal Personality Disorder includes:

Answer 37

* Population rarely seeks treatment; thus, counselors are challenged to engage them and must built trust, create a safe environment, and develop a strong connection with them * Counselors need to be prepared to manage discomfort with clients’ strange, odd, and eccentric reactions, ideas, and behaviors; nonjudgement is important * Too much personal exploration should be avoided due to clients’ tendency to decompensate * Assess for common disorder that co-occur

Question 38

Treatment for Schizotypal Personality Disorder include:

Answer 38

Psychoeducation, CBT, Case management, and Psychopharmacotherapy

Question 39

What is the most effective approach to treating those with Schizotypal Personality Disorder?

Answer 39

A combination of psychotropic medication and psychosocial therapies

Question 40

Which personality disorder is characterized by inability and lack of desire to form social relationships

Answer 40

Schizoid Personality Disorder

Question 41

Counselor Considerations for Schizoid Personality Disorder inclundes

Answer 41

• Therapeutic trust is one of the most essential characteristics needed in treatment • External motivations for seeking counseling should be utilized and fully explored • Areas to be assessed: interpersonal functioning, eccentric behaviors, social aversion and withdrawal, personality function, and any common comorbid mental disorders • Determine cultural and situational factors that may better account for clients’ behaviors

Question 42

Treatment for Schizoid Personality Disorder include:

Answer 42

Behavior Therapy and CBT

Question 43

Which personality disorder is characterized by suspiciousness; a general mistrust of others

Answer 43

Paranoid Personality Disorder

Question 44

Counselor Considerations for Paranoid Personality Disorder includes:

Answer 44

• Those with PPD do not typically seek counseling due to being prone to externalizing and lack of insight • Consider client’s cultural background prior to diagnosis • Provide clients with control over session frequency, encourage them to be active in developing counseling goals and tasks, and allow them to determine the focus of sessions • Be mindful of personal reactions; avoid being overly effusive • Differentiate between PPD and other disorder that appear similar and assess for comorbid personality disorder diagnoses

Question 45

Treatments for Paranoid Personality Disorder include:

Answer 45

Behavior Therapy, CBT, and Medication to treat anxiety and depressive symptoms while antipsychotic may be useful in addressing paranoid ideation.