Treatment of personality disorder: skills-based therapies

Evershed, Sue

doi:10.1192/apt.bp.109.006973

Cited by 3 publications

(1 citation statement)

References 40 publications

(36 reference statements)

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“…The fundamental principle of CBT for complex personality disorders, as explained by Evershed (2011), is the formation of a functional therapeutic alliance. Such process would be initiated at the beginning of therapy and should focus on the development of mutual understanding of reported difficulties (formulation), eventually leading to the establishment of trust and collaboration.…”

Section: Literature Reviewmentioning

confidence: 99%

Increasing Psychosocial Health with Cognitive Therapy in Schizoid Personality Disorder: A Single Subject Design

Mankiewicz¹,

Renton²

2019

AJHMS

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Schizoid personality disorder (SPD) has been characterised by a persistent detachment from, and indifference to, interpersonal relationships, alongside restricted range of expressed emotions, and limited rewards gained from social interactions, resulting in limited levels of socially healthy behaviour. Although the applicability of evidencebased psychological treatments, including cognitive therapy (CT), has been indicated, there is a noticeable scarcity of relevant academic literature that might inform clinical practice in mental health clinics. This rigorous single subject design study attempts to address such apparent gap in literature. Sixteen sessions of CT were undertaken with an individual diagnosed with SPD and comorbid mood disorder in a community-based mental healthcare setting. Formal standardised measurement, behaviour frequency sampling, and subjective data were utilised to systematically evaluate the outcomes, indicating a considerable improvement in psychosocial functioning. The paper highlights the pertinence of cognitive and behavioural strategies in helping schizoid individuals address their interpersonal difficulties, reduce emotional distress, acquire socially inclusive behaviour, and ultimately increase their psychosocial health, without the need for explicitly intervening with their underlying personality traits.

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Section: Literature Reviewmentioning

confidence: 99%

Increasing Psychosocial Health with Cognitive Therapy in Schizoid Personality Disorder: A Single Subject Design

Mankiewicz¹,

Renton²

2019

AJHMS

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Co-occurring psychiatric disorders and alcoholism

Martín

2014

Handbook of Clinical Neurology

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Personality disorder service provision: a review of the recent literature

Evans

Sethi²,

Dale

et al. 2017

MHRJ

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Purpose The purpose of this paper is to describe the evolution of the field of personality disorder since the publication of “Personality disorder: no longer a diagnosis of exclusion” in 2003. Design/methodology/approach A review of both the academic literature contained within relevant databases alongside manual searches of policy literature and guidance from the key stakeholders was undertaken. Findings The academic and policy literature concentrates on treating borderline and antisocial personality disorders. It seems unlikely that evidence will resolutely support any one treatment modality over another. Criticism has arisen that comparison between modalities misses inter and intra patient heterogeneity and the measurement of intervention has become conflated with overall service design and the need for robust care pathways. Apparent inconsistency in service availability remains, despite a wealth of evidence demonstrating the availability of cost-effective interventions and the significant inequality of social and health outcomes for this population. Research limitations/implications The inclusion of heterogeneous sources required pragmatic compromises in methodological rigour. Originality/value This paper charts the recent developments in the field with a wealth of wide-ranging evidence and robust guidance from institutions such as NICE. The policy literature has supported the findings of this evidence but current clinical practice and what patients and carers can expect from services remains at odds. This paper lays bare the disparity between what we know and what is being delivered. The authors argue for the need for greater research into current practice to inform the setting of minimum standards for the treatment of personality disorder.

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Treatment of personality disorder: skills-based therapies

Cited by 3 publications

References 40 publications

Increasing Psychosocial Health with Cognitive Therapy in Schizoid Personality Disorder: A Single Subject Design

Increasing Psychosocial Health with Cognitive Therapy in Schizoid Personality Disorder: A Single Subject Design

Co-occurring psychiatric disorders and alcoholism

Personality disorder service provision: a review of the recent literature

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