copyright © 2002 by w. b. saunders company. all rights reserved. chapter 16 personality disorders...
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Chapter 16
Personality Disorders
Chapter 16
Personality Disorders
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Mental health continuum for personality disordersMental health continuum for personality disorders
16-216-2 (Fig. 16-1)(Fig. 16-1)
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Personality DisordersPersonality Disorders
Cluster CAnxious, Fearful
Dependent
Avoidant
Obsessive Compulsive
Cluster B Dramatic, Emotional,
Erratic
Borderline
Antisocial
Histrionic
Narcissistic
Cluster AOdd or
Eccentric
Schizotypal
Paranoid
Schizoid
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Limits: clear, consistent, enforceable
Team: aware of limits, need for consistency Communicate expectations to client
Be realistic re: which behaviors to limit
Clear consequences of exceeding limits
Follow through with consequences in non-punitive manner
Assist client to limit own behavior
Assess insight and motivation to change
Avoid power struggles
Limits: clear, consistent, enforceable
Team: aware of limits, need for consistency Communicate expectations to client
Be realistic re: which behaviors to limit
Clear consequences of exceeding limits
Follow through with consequences in non-punitive manner
Assist client to limit own behavior
Assess insight and motivation to change
Avoid power struggles
Limit SettingLimit Setting
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Identify antecedent needs and feelings
Discuss current/previous impulsive acts
Explore impact on self and others
Recognize cues to impulsive behavior
Refer or teach needed coping skills
Discuss alternatives to impulsive behavior
Role play new skills
Provide feedback
Support new skills
Identify strengths and effective communication
Identify antecedent needs and feelings
Discuss current/previous impulsive acts
Explore impact on self and others
Recognize cues to impulsive behavior
Refer or teach needed coping skills
Discuss alternatives to impulsive behavior
Role play new skills
Provide feedback
Support new skills
Identify strengths and effective communication
Impulsive Behavior: InterventionsImpulsive Behavior: Interventions
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Be aware of client isolation, suspiciousness
Avoid being “too nice,” overly friendly
Use neutral, kind approach
Clear, straightforward explanations
Simple, clear language
Give warning about changes, reasons for delay, medication side effects
Be aware of client isolation, suspiciousness
Avoid being “too nice,” overly friendly
Use neutral, kind approach
Clear, straightforward explanations
Simple, clear language
Give warning about changes, reasons for delay, medication side effects
Cluster A Clients: InterventionsCluster A Clients: Interventions
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Set clear, realistic goals
Be aware of manipulative behaviors
Clear, consistent boundaries/limits
For behavioral problems, review therapeutic goals and treatment boundaries
Avoid rejecting, rescuing
Assess for suicidal, self-mutilating behavior
Set clear, realistic goals
Be aware of manipulative behaviors
Clear, consistent boundaries/limits
For behavioral problems, review therapeutic goals and treatment boundaries
Avoid rejecting, rescuing
Assess for suicidal, self-mutilating behavior
Borderline Personality Disorder: InterventionsBorderline Personality Disorder: Interventions
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Set clear, realistic limits on specific behavior
All limits adhered to by all staff
Document objective physical signs of manipulation or aggression
Provide clear boundaries, consequences
Guard against letting client make you feel guilty
Guard against being manipulated
Set clear, realistic limits on specific behavior
All limits adhered to by all staff
Document objective physical signs of manipulation or aggression
Provide clear boundaries, consequences
Guard against letting client make you feel guilty
Guard against being manipulated
Antisocial Personality Disorder: InterventionsAntisocial Personality Disorder: Interventions
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Stay neutral, avoid power struggles
Don’t be defensive when disparaged
Convey unassuming self-confidence
Stay neutral, avoid power struggles
Don’t be defensive when disparaged
Convey unassuming self-confidence
Narcissistic Personality Disorder: InterventionsNarcissistic Personality Disorder: Interventions
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Understand seductive behavior as a response to stress
Keep relationship professional
Encourage/model use of concrete descriptive language
Teach and model assertiveness
Understand seductive behavior as a response to stress
Keep relationship professional
Encourage/model use of concrete descriptive language
Teach and model assertiveness
Histrionic Personality Disorder: InterventionsHistrionic Personality Disorder: Interventions
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