Personality disorder
Personality disorder is one of the most fascinating and relevant concepts in mental health. The days here cover:
What is personality disorder
Covering
- The nature of personality
- The major dimensions of personality
- The concept of personality disorder
- DSMIV and ICD10 categories of personality disorder
- The usefulness of personality disorder as a diagnosis
- The major categories of PD in clinical practice: borderline (impulsive), antisocial, dangerous severe personality disorder
- PD as a contaminating factor in (e.g.) depression
- Current facilities for the treatment of PD
- An overview of the major approaches to the treatment of PD
Format
Lecture, discussion, case examples. End of day quiz.
Note
This input is designed to address fully the title of the day. Although it will give you an overview of treatment methods it does not of itself equip you to treat people with PD.
Assessment & case conceptualisation
Covering
- Assessment methods, including: questionnaire, behavioural observation/recording and interview
- Case conceptualisation, including: precipitating factors - why has the problem developed
- Maintaining factors - what helps to maintain the problem behaviour
- Factors necessary to bring about improvement (e.g. the patient showing increased empathy for others)
- What kind of interventions might achieve those factors (e.g. how might we increase the patient’s ability to feel empathy)
- The hierarchy of targets in individual therapy
- Responding to maladaptive behaviour in a way that shows interest and concern but avoids reinforcing the behaviour
Format
Lectures, case-presentations, exercises in analysing presented cases. End of day quiz.
Note
This input is designed to address fully the title of the day. Although it covers an essential skill if you are to treat PD and will give you an overview of treatment methods it does not by itself equip you to treat people with P.D.
Forming & managing good working relationships
Covering
- The types of personality disorder and characteristic difficulties that crop up with each
- How to respond to those difficulties. Why this topic is especially relevant when treating Personality Disorder
- Validation: its importance and how to do it. (See also under Treatment Methods)
- The pushing of boundaries, the tendency to over-familiarity, the tendency to ask for things that cannot be given
- Possible responses to each that (a) maintain the boundaries and (b) maintain a good working relationship Formats for service-delivery where 24/7 cover is required.
Format
Lectures, case-presentations, exercises and discussion of examples. End of day quiz.
TM1: Developing Insight and Motivation – essential for any progress
Covering
- Enabling the person to reflect upon the past, whether specific events over the last week or life in general
- How to discuss why some things go well and some go badly
- Validation: its importance and how to do it
- Analysing the triggers for problematic behaviour in a way that invites the wish to respond differently
- Consolidating insights gained in one session, to avoid the ‘back to square one’ phenomenon in the next
- Using ‘decisional balance’ and recognising ambivalence in decision-making
Format
Lectures, case-presentations, exercises and discussion of cases. End of day quiz.
TM2: How to work out an effective plan for the future
Covering
- Planning is a naturally enjoyable activity in personality disorder: it holds out the (realistic) hope of a brighter future
- To be in this planning stage you must however have achieved the reflection / analysis / motivation targets from Treatment I
- Methods for eliciting realistic plans from the client
- What to do (a) when the client has no good ideas and (b) when the client has unrealistic plans
- What to do when you yourself have no good ideas
- How to help the client acquire new skills – increased tolerance of distress for example – necessary to a plan
Format
Lectures, case-presentations, exercises and discussion of cases. End of day quiz.
TM3: developing adherence to the treatment plan
Covering
- Having an energising and inspiring plan helps immensely at this point
- Collaborative empiricism: the spirit of working together and trying things out. Modifying the plan if necessary
- How to set assignments that are in line with the plan: what to do when the client doesn’t do what s/he agreed to do
- Why it is so important to spot and enquire about progress – things going right. Why it is so difficult to do: why progress is often invisible even when there, why this is such a problem, and how to solve it
- Problem-solving: its role here and how to do it
- The trap of too-early discharge: why people really continue wanting to see us
- What to do about lapse and relapse: broken relationships with the client and how to re-engage
Format
Lectures, case-presentations, exercises and discussion of cases. End of day quiz.
There is an OPTIONAL EXAM for those who attend at least 5 of the 6 days.
Format
- Exam is taken in traditional (no notes, no talking) format
- Most questions are either in multiple choice format or require brief, ‘right or wrong’ answers
- All questions relate clearly to what has been taught and the notes received on the courses
- Two levels of success: pass and distinction. Success at either level indicates a significant level of knowledge and understanding
- Successful completion leads to award of certificate from A.P.T. testifying to your success