Therapy For Clients With Personality Disorders 574270

Therapy for Clients with Personality Disorders Being able to treat a client with a personality disorder requires finesse on the part of the practitioner which includes and understanding of the client and his or her stage of acceptance. Depending on the disorder being treated and the age and stage of the client, one can utilized a customized therapeutic approach which can include psychotropic medication as well as psychotherapy. In some cases, one can attempt psychotherapy alone and then if necessary, add medication. For someone who is new in the field of psychotherapy such as a nurse practitioner student or advanced practice nurse, CBT can be simple and straightforward to utilize.

Effective therapy for clients with personality disorders necessitates a nuanced understanding of the individual’s unique presentation and stage of acceptance, requiring a tailored therapeutic approach. Evidence suggests that integrating pharmacotherapy with psychotherapy enhances treatment outcomes, especially for complex conditions like personality disorders (Leichsenring et al., 2018). Cognitive Behavioral Therapy (CBT) is often a pragmatic choice for novice practitioners, including nurses and nurse practitioners, owing to its structured and straightforward methodology. Despite its simplicity, the effectiveness of CBT delivered by less experienced therapists has been documented, indicating that even therapists with limited training can produce meaningful improvements (Stark & Rø, 2016). Nevertheless, the treatment plan for personality disorders must be personalized, often combining psychotherapy with psychotropic medications to address different aspects of the disorder.

Focusing on Bipolar II Disorder, which is characterized by hypomanic episodes alongside depressive episodes, clinical management involves a combination of medication and psychotherapy (American Psychiatric Association [APA], 2013). Unlike Bipolar I, Bipolar II involves mood episodes that do not escalate to full manic episodes, complicating diagnosis and treatment adherence. Pharmacotherapy primarily involves mood stabilizers such as lithium or anticonvulsants like Depakote, aimed at controlling mood fluctuations and preventing relapse (Chatterton, 2017). However, medication adherence remains a challenge due to side effects, stigma, and the client’s perceived improvements, often leading to relapse (Chatterton, 2017). Incorporating psychoeducation alongside CBT can enhance medication compliance, identify early signs of mood episodes, and improve overall functioning.

When addressing a diagnosis with clients, a sensitive, client-centered approach is essential. Initiating conversations by explaining symptoms and their impact on daily functioning in neutral terms helps foster trust and understanding. Once the client recognizes shared experiences and begins to grasp the nature of the disorder, the clinician can introduce the diagnosis in a supportive manner. This includes discussing treatment options, emphasizing the role of CBT and medication, and collaborating on a personalized plan that respects the client’s readiness and acceptance level (Miklowitz & Chung, 2016). Such an approach is vital for promoting engagement, reducing stigma, and empowering clients to participate actively in their treatment process.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
• Chatterton, M. L. (2017). Psychosocial therapies for the adjunctive treatment of bipolar disorder in adults: network meta-analysis. British Journal of Psychiatry, 210(5), 333–341.
• Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2018). Borderline personality disorder. The Lancet, 391(10119), 1355-1364.
• Miklowitz, D. J., & Chung, B. (2016). Adjunctive psychotherapy for bipolar disorder: State of the evidence. American Journal of Psychiatry, 173(8), 719-729.
• Stark, V., & Rø, T. (2016). Affect at the different phases of cognitive behavioral therapy: An evaluation of psychotherapy provided by candidates. Scandinavian Journal of Psychology, 57(1), 36-44.