Therapy for Clients with Personality Disorders

Discussion: Therapy for Clients With Personality Disorders-WK1164N
Clients with personality disorders often find it difficult to overcome their problems and function in daily life. Even when these clients are aware that they have a dysfunction with their personality and are open to counseling, treatment can be challenging for both the client and the therapist. For this Discussion, as you examine personality disorders, consider therapeutic approaches you might use with clients. Therapy for Clients with Personality Disorders
Learning Objectives
Students will:
• Analyze therapeutic approaches to treating clients with personality disorders
To prepare:
• Review this week’s Learning Resources and reflect on the insights they provide.
• Select one of the personality disorders from the DSM-5.
QUESTION
Post a description of the personality disorder you selected ( SELECT AN OLDER ADULT WITH PERSONALITY DISORDER IN THEE NURSING HOME) .

  1. Explain a therapeutic approach you might use to treat a client presenting with this disorder,
  2. Including psychotropic medications if appropriate) you might use to treat a client presenting with this disorder,
  3. Include how you would share your diagnosis of this disorder to the client in order to avoid damaging the therapeutic relationship. Support your approach with evidence-based literature.
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A description of borderline personality disorder

Jenny is an 80 year old female diagnosed with borderline personality disorder. Her major symptoms include emotional instability, suicidal thoughts, low mood feelings, outbursts of rage and anxiety. According to Stoffers-Winterling et al (2012), borderline personality disorder is marked by widespread pattern of variability in impulse control, affect regulation, self- image and interpersonal relationships.

Clinical hallmarks entail impulsive aggression, emotional deregulation, and repetitive self-injury along with chronic suicidal ideation. Patients with borderline personality disorder usually have problems regulating their impulses and emotions, and find it difficult to maintain relationships. They may suffer swift alterations in mood, experience feelings of desolation and may injure themselves (Stoffers-Winterling et al, 2012).

Therapeutic approach i might use to treat a client presenting with borderline personality disorder

The most effective therapeutic therapy that I can use to treat a client presenting with the disorder is dialectical behavioral therapy. This therapy is a form of cognitive behavioral therapy that provides patients with novel skills of managing painful emotions and lessening struggles in relationships. According to Biskin and Paris (2012), dialectical behavioral therapy has a strict order of targets for treatment and life-threatening behavior at the topmost of the hierarchy. A major dialectics in the treatment of borderline personality disorder is the equilibrium that the psychotherapist must attain in authenticating the behaviors and experiences of the client whilst enhancing change. Therapy for Clients with Personality Disorders

The therapy entails weekly life-skills sessions that impart skills in four domains, including mindfulness, interpersonal effectiveness, emotions regulation, distress tolerance and mindfulness. Distress tolerance focuses on increasing an individual’s tolerance to adverse emotion, other than attempting to run away from it. Mindfulness focuses on promoting the ability of the client to acknowledge the present moment. Interpersonal effectiveness comprises techniques that permit the client to communicate with other people in an assertive way that strengthens relationships and maintains self-respect. Emotion regulation entails strategies of managing and changing extreme emotions that cause problems in the life of the client (Biskin & Paris, 2012),

Use of psychotropic medications to treat a client presenting borderline personality disorder

Psychotropic medications that i can use to treat a client with this disorder include antidepressants, mood stabilizers, antipsychotic medications, and sedatives. Bradford and Holt (2015) argue that psychotropic medications are normally regarded as second-line treatment after psychotherapy, though they can be used to treat borderline personality disorder. Nevertheless, there is no evidence for the single best medication for borderline personality disorder and the majority of researchers recommends that drug therapy must be targeted towards individual symptoms of the disorder.

As Martinho et al (2015) indicate, people with borderline personality disorder receive as –needed psychotropic drugs, regardless of lack of evidence of their effectiveness. Psychotropic medication is used in patients with a borderline personality disorder to alleviate symptoms like agitation, sleep disturbance, anger, impulsivity, transient psychosis and intensified emotional liability. When a patient represents these symptoms, the caregiver, patient or nurse decides when the medications are administered, under a preceding prescribed medication regimen (Martinho et al, 2015).

How I would share my diagnosis of borderline personality disorder in order to avoid damaging the therapeutic relationship

I would share my diagnosis of the disorder by offering a detailed description of the disorder in an honest manner. Cultivating a productive emotional relationship is an effective strategy for developing and sustaining a progressive therapeutic relationship. According to McMain et al (2015), emotional awareness is important in therapeutic interaction since emotional reactivity and sensitivity of either the therapist or the client can hinder therapeutic procedure and obstruct a positive therapeutic connection from developing. Tension and conflict in therapeutic relationship are intensified when either the client or therapist disregards them until they overwhelm both parties. So as to cultivate a positive therapeutic relationship, it will be crucial that diagnosis and therapy take in the emotions of both the therapist and the client. Therapy for Clients with Personality Disorders

References

Bradford, R., & Holt, C. (2015). The Use of Psychotropic Drug Therapy in Borderline Personality Disorder: A Case Report. Psychiatric Danubina, 27(Suppl 1): S371- S374.

Biskin, R., & Paris, J. (2012). Management of borderline personality disorder. Canadian Medical Association Journal, 184(17): 1897-1902.

Martinho, E., Frankenburg, F., Fitzmaurice, G., & Zanarini, M. (2015). PRN (As-Needed) Psychotropic Medication Use in Borderline Patients and Other Personality –Disorder Subjects over 14 Years of Prospective Follow-up. Journal of Clinical Psychopharmacology, 34(4): 499-503.

McMain, S., Labyman, M., & Boritz, T. (2015). Common strategies for cultivating a positive therapy relationship in the treatment of borderline personality disorder. Journal of Psychotherapy Integration, 25(1): 20-29.

Stoffers-Winterling, J., Vollom, B., & Rucker, G et al. (2012). Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Reviews, 15(8): CD 005652. Therapy for Clients with Personality Disorders

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