Discussion: Therapy For Clients With Personality Disorders

Discussion Therapy For Clients With Personality Disordersclients With

Describe the personality disorder you selected from the DSM-5. Explain a therapeutic approach you might use to treat a client with this disorder, including the use of psychotropic medications if appropriate. Detail how you would communicate the diagnosis to the client in a manner that preserves the therapeutic relationship. Support your approach with evidence-based literature.

Paper For Above instruction

Personality disorders are complex mental health conditions characterized by enduring patterns of inner experience and behavior that deviate markedly from cultural expectations, are pervasive and inflexible, and lead to significant distress or impairment (American Psychiatric Association, 2013). For this discussion, I have selected Borderline Personality Disorder (BPD) from the DSM-5, a condition distinguished by instability in interpersonal relationships, self-image, affect, and marked impulsivity (Lieb et al., 2004).

Borderline Personality Disorder affects approximately 1.6% of the general population, with a higher prevalence among women (Lenzenweger et al., 2007). Patients with BPD often experience intense fear of abandonment, chronic feelings of emptiness, mood swings, and self-harming behaviors, which complicate treatment efforts and strain therapeutic relationships (Linehan, 1993). An effective therapeutic intervention for BPD is Dialectical Behavior Therapy (DBT), developed by Marsha Linehan (1993), which combines cognitive-behavioral techniques with mindfulness strategies to help clients regulate emotions, reduce self-destructive behaviors, and improve interpersonal skills.

DBT is pertinent because it addresses core features of BPD such as emotional dysregulation and impulsivity. The therapy involves individual sessions, group skills training, and phone coaching to provide ongoing support outside of sessions (Linehan, 2015). A critical component of DBT is validation—the therapist's acknowledgment of the client's feelings and experiences—which fosters trust and reduces defensiveness (Linehan, 1990). Literature consistently supports DBT’s effectiveness, with findings indicating significant reductions in suicidal ideation, self-harm, and hospitalization rates among BPD patients (Stoffers et al., 2012; Kliem et al., 2010).

In some cases, psychotropic medications are utilized as adjuncts to psychotherapy to manage specific symptoms like mood swings, impulsivity, or transient psychotic episodes (Paris et al., 2017). For instance, mood stabilizers such as lamotrigine or atypical antipsychotics like aripiprazole may help stabilize affect and reduce impulsivity (Kirk et al., 2014). However, medication alone is insufficient; it must be part of a comprehensive treatment plan that includes psychotherapy.

When discussing the diagnosis of BPD with the client, it is essential to do so with sensitivity to minimize potential stigma and protect the therapeutic alliance. I would approach the conversation by emphasizing the biological and environmental factors contributing to the disorder and framing diagnosis as a step toward understanding and managing symptoms. For example, I might say, "Based on our discussions and your experiences, it appears you have some patterns that align with Borderline Personality Disorder. Recognizing this can help us tailor your treatment to better support your needs and goals." Such an approach maintains respect, reduces shame, and encourages collaboration (Gunderson et al., 2014).

In conclusion, DBT remains a gold standard therapy for BPD, especially when combined with appropriate pharmacological management. The way clinicians communicate the diagnosis plays a pivotal role in the success of treatment, reinforcing the client’s hope for recovery and resilience.

References

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
• Kirk, K., McCarthy, J., & Sheehan, G. (2014). Pharmacotherapy for borderline personality disorder. Journal of Psychopharmacology, 28(4), 400-408.
• Kliem, S., Korb, S., & Lieb, K. (2010). Dialectical behavior therapy for borderline personality disorder. Cochrane Database of Systematic Reviews, (5).
• Lenzenweger, M. F., et al. (2007). Epidemiology of borderline personality disorder. American Journal of Psychiatry, 164(9), 1364-1372.
• Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
• Linehan, M. M. (2015). DBT skills training manual. Guilford Publications.
• Lieb, K., et al. (2004). Borderline personality disorder. The Lancet, 364(9432), 453-464.
• Paris, J., et al. (2017). Pharmacotherapy of borderline personality disorder. Psychiatric Clinics, 40(1), 125-144.
• Stoffers, G. M., et al. (2012). Dialectical behavior therapy for borderline personality disorder. The Cochrane Database of Systematic Reviews, (8).
• Gunderson, J. G., et al. (2014). Treating borderline personality disorder. Guilford Publications.