To prepare:
- Review this week’s Learning Resources below and reflect on the insights they provide about treating clients with personality disorders.
- Select one of the personality disorders from the DSM-5-TR (e.g., paranoid, antisocial, narcissistic). Then, select a therapy modality (individual, family, or group) that you might use to treat a client with the disorder you selected.
The Assignment:
Succinctly, in 2 pages, address the following:
- Briefly describe the personality disorder you selected, including the DSM-5-TR diagnostic criteria.
- Explain a therapeutic approach and a modality you might use to treat a client presenting with this disorder. Explain why you selected the approach and modality, justifying their appropriateness.
- Next, briefly explain what a therapeutic relationship is in psychiatry. Explain how you would share your diagnosis of this disorder with the client in order to avoid damaging the therapeutic relationship. Compare the differences in how you would share your diagnosis with an individual, a family, and in a group session.
Support your response with specific examples from this week’s Learning Resources and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.
Learning resources example
https://www.youtube.com/watch?v=ewBFri65Quw
https://www.youtube.com/watch?v=knfVjj3P9es
Therapy for Clients with Personality Disorders
Name
Institution
Date
Therapy for Clients with Personality Disorders
DSM-V Criteria for Anti-social Personality Disorder
Anti-social personality disorder refers to a mental health illness, which is characterized by patterns of irresponsible behavior, exploitation, and guiltless behavior. The DSM-V criterion provides four diagnostic criteria for the condition. The first criterion is a disregard and violation of other people’s rights since the age of 15 years. The seven sub-types of the above criterion that psychiatrists should look out for include the failure by individuals to obey rules and norms resulting in arrests or issuance of warrants of arrest, patterns of lying, manipulation, deception for self-amusement or profit, aggression, and irritability (American Psychiatric Association, 2013). Others include blatant disregard for the safety of self and others, impulse behavior, a pattern of irresponsibility, and lack of remorse for actions. The other three criteria are that the individual should be 18 years and above, there should be the presence of conduct disorder history before the age of 15 years, and the anti-social behavior and lastly the anti-social behavior should not occur in the context of either schizophrenia or bipolar disorder (American Psychiatric Association, 2013).
Therapeutic Approach
There lacks a consensus on the effective treatment and management approach for individuals suffering from an antisocial personality disorder (American Psychiatric Association, 2013). It is vital to note that most of the health needs of individuals suffering from anti-social personality disorder are managed in an outpatient care setting since patients who are referred to hospitalization are those that tend to present with co-occurring conditions and complications such as withdrawal symptoms. Due to the lack of sufficient, the most recommended therapeutic approach that I would use to manage a patient with anti-social personality disorder would be the use of pharmacological agents for the management of co-occurring conditions such as aggression and impulsivity, which are some of the symptoms that patients can present with. Some of the medications that can manage aggression include risperidone 4 mg/day or quetiapine 100 mg/day (Fisher & Hany, 2021). For impulsivity, the patient can be put on anticonvulsants such as carbamazepine or oxcarbazepine. The use of the medications above would ensure that the patient’s conduct is controlled hence lowering the possibility of the patient getting into trouble with the law or better still inflicting pain on other people.
Therapeutic Relationship in Psychiatry
A therapeutic relationship refers to the close association that exists between a patient seeking therapy and a healthcare professional. A therapeutic relationship encompasses three concepts namely mutual ability to agree on the goals, a collaborative nature, and an effective bond that must exist between the patient and the therapist (Bolsinger et al., 2020). A good patient-therapist relationship has been associated with improved patient satisfaction, positive patient outcomes, and a low incidence of re-hospitalization. I would share the diagnosis with the patient by making him/her understand the importance of accurate diagnosis to minimize complications. More so, I would ensure privacy and give the patient adequate time to process the news and ask questions. I would reassure the patient of support and show empathy.
When sharing the news in an individual setting, the environment would provide privacy and confidentiality to the patient as compared to a group and family setting. In a group setting, there would arise issues related to privacy and confidentiality on the diagnosis news, which would affect relations with other group members. In a family setting, considering members of a family are related, it would require that the family members show understanding; support, and empathy as compared to judgments to enable the person to cope and even adhere to treatment and therapy. The three scholarly sources were chosen because they are peer-reviewed and contain evidence-based literature.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. (5th Edition). Washington, DC.
Bolsinger, J., Jaeger, M., Hoff, P., & Theodoridou, A. (2020). Challenges and Opportunities in Building and Maintaining a Good Therapeutic Relationship in Acute Psychiatric Settings: A Narrative Review. Frontiers in psychiatry, 10, 965. https://doi.org/10.3389/fpsyt.2019.00965
Fisher, K. A., Hany, M., & Doerr, C. (2021). Antisocial Personality Disorder (Nursing).