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| CBT The Center for Brief Therapy, PC, 10319 Dawson's Creek Blvd, Suite J, Fort Wayne, Indiana, USA 46825 260-969-5583; fax 260-969-5584; email: freemancbt@aol.com |
Workshop #1
Cognitive Behavior Therapy with Personality Disorders
Arthur Freeman, EdD, ABPP and Sharon Morgillo Freeman, PhD, APRN-CS
The patients whose clinical syndromes are coded on Axis II, according to DSM-IV, are often the most difficult
in the therapist’s caseload. They may require more time in therapy and greater therapist energy without much
progress or change. They usually enter therapy for issues other than the personality disorder, notably Axis I
depression and anxiety. Progress in these clients may be slow or stopped by the Axis II problems.
Cognitive Behavioral Treatment of Patients with Personality Disorders
Patients with Personality Disorders, are often among the most difficult in the therapist's caseload. They may
require more time in therapy and greater therapist energy than other patients while making less progress or
change. They usually enter therapy for issues other than the personality disorder, notably depression and
anxiety or at the demand of others. Progress with these clients may be slowed or stopped by the personality
problems. These patients can become the individuals that therapists “love to hate,” in that they frequently
arouse intense negative countertransference. Often misunderstood or poorly conceptualized, personality
disorders will be discussed in terms of assessment, diagnosis, conceptualization, and treatment.
This workshop will briefly review the theoretical, conceptual, and developmental issues in the etiology and
treatment of personality disorders described in the Diagnostic and Statistical Manual, 4th Edition-Text
Revision (DSM IV-TR, 2000)
Among the topics to be covered in the workshop will be: assessment and diagnostic criteria; concomitant
psychological problems; treatment planning using Freeman's Diagnostic Profile System; issues of non-
compliance with therapeutic regimen; treatment success and failure, and therapist response. Assessment
and treatment will be illustrated through the use of videotaped examples. Of special interest will be
Freeman's revision of the widely used Stages of Change developed by Prochaska & DiClemente.
Substance use or misuse that is often a primary factor or an aggravating factor of underlying personality
difficulty. Differentiation of personality disorder and substance misuse that adversely affect the person’s
ability to participate in or profit from therapy will be reviewed. Specifically, substance misusing individuals
may exhibit cognitive impairment, increased impulsivity, increased irritability, decreased problem solving
ability and difficulty concentrating. They may also exhibit irritability, exaggerated startle response,
hypervigilance, depression and withdrawal, difficulty sleeping and trusting others. In addition, 0rganic factors
such as brain damage caused by long term substance use directly impact the individual’s ability to respond
to therapy. These behaviors can be easily confused with personality disorders, and when co-mingled,
increase the complexity of treatment. It is highly likely that a significant number of persons seeking treatment
have co-existing personality disorders, co-existing substance misuse disorders, or both. Teaching
techniques will include didactic presentation and videotapes of patients with personality disorder.
Workshop Objectives
At the conclusion of this workshop, participants will be able to:
* Identify and describe the steps required to develop a Cognitive Behavioral treatment conceptualization
for treating patients with personality disorders
* Use the Diagnostic Profiling System (DPS) to gather data and direct the therapy plan
* Define four areas of impediment to therapeutic progress
* Describe substance misusing presentations that may be mistaken for personality disorder
* Explain the importance of conducting routine substance use screening with patients who exhibit
personality disorder presentation
* Describe the rationale for using cognitive and behavioral interventions
* Identify five cognitive interventions for treating patients with personality disorders
* Identify five behavioral interventions for treating patients personality disorders
* Identify the steps in Freeman's revision of the Stages of Change
* Compare and contrast symptoms of personality disorders and substance misuse.
* Describe a treatment model for treating the co-morbidity.
•About the relevant theory, assessment techniques (including the newly developed Diagnostic Profiling
System), and general treatment considerations;
•About the conceptualisation and treatment strategies for each of the three clusters of personality disorders
described by DSM-IV;
•How to differentiate between Personality Disorders and Substance Misuse Disorders
•About issues of noncompliance or impediments to the therapeutic regimen, along with techniques for
increasing compliance and collaboration; and
•About therapeutic alliance, which will be highlighted as essential for the treatment of this patient group.
Modification of the basic cognitive therapy format will be discussed and illustrated through the use of clinical
vignettes and videotape. The therapeutic goals of schematic reconstruction, schematic modification,
schematic reinterpretation, and schematic camouflage will be discussed.
Recommended Readings: Beck, A.T., Freeman, A., Davis, D. & Associates (2005). Cognitive therapy of
personality disorders, 2nd Ed. New York: Guildford Press. Layden, M.A., Newman, C.F., Freeman, A., &
Byers-Morse, S. (1993) Cognitive therapy for borderline personality disorder: Needham, MA:Allyn and
Bacon. (1995)
WORKSHOP #2:
Treatment of Patients with Narcissistic Personality Disorder
The patients with Narcissistic Personality Disorder (NPD), are often among the most difficult in the therapist's
caseload. They may require more time in therapy and greater therapist energy than other patients while
making less progress or change. They usually enter therapy for issues other than the NPD, notably
depression and anxiety or at the demand of others. Progress with these clients may be slowed or stopped by
the personality problems. These patients can become the individuals that therapists “love to hate,” in that
they frequently arouse intense negative countertransference. Often misunderstood or poorly conceptualized,
NPD will be discussed through the lenses of several theoretical models.
This workshop will briefly review the theoretical, conceptual, and developmental issues in the etiology and
treatment of NPD described in the Diagnostic and Statistical Manual, 4th Edition-Text Revision (DSM IV-TR,
2000)
Among the topics to be covered in the workshop will be: assessment and diagnostic criteria; concomitant
psychological problems; treatment planning using Freeman's Diagnostic Profile System; issues of non-
compliance with therapeutic regimen; treatment success and failure, and therapist response. Assessment
and treatment will be illustrated through the use of videotaped examples. Of special interest will be
Freeman's revision of the widely used Stages of Change developed by Prochaska & DiClemente.
Teaching techniques will include didactic presentation and videotapes of patients with NPD.
Workshop Objectives
At the conclusion of this workshop, participants will be able to:
• Identify and describe the steps required to develop a Cognitive Behavioral treatment conceptualization
for treating patients with NPD
• Use the Diagnostic Profiling System (DPS) to gather data and direct the therapy plan
• Define four areas of impediment to therapeutic progress
• Describe the rationale for using cognitive and behavioral interventions
• Identify five cognitive interventions for treating patients with NPD
• Identify five behavioral interventions for treating patients NPD
• Identify the steps in Freeman's revision of the Stages of Change.
Cognitive Behavior Therapy with Personality Disorders
Arthur Freeman, EdD, ABPP and Sharon Morgillo Freeman, PhD, APRN-CS
The patients whose clinical syndromes are coded on Axis II, according to DSM-IV, are often the most difficult
in the therapist’s caseload. They may require more time in therapy and greater therapist energy without much
progress or change. They usually enter therapy for issues other than the personality disorder, notably Axis I
depression and anxiety. Progress in these clients may be slow or stopped by the Axis II problems.
Cognitive Behavioral Treatment of Patients with Personality Disorders
Patients with Personality Disorders, are often among the most difficult in the therapist's caseload. They may
require more time in therapy and greater therapist energy than other patients while making less progress or
change. They usually enter therapy for issues other than the personality disorder, notably depression and
anxiety or at the demand of others. Progress with these clients may be slowed or stopped by the personality
problems. These patients can become the individuals that therapists “love to hate,” in that they frequently
arouse intense negative countertransference. Often misunderstood or poorly conceptualized, personality
disorders will be discussed in terms of assessment, diagnosis, conceptualization, and treatment.
This workshop will briefly review the theoretical, conceptual, and developmental issues in the etiology and
treatment of personality disorders described in the Diagnostic and Statistical Manual, 4th Edition-Text
Revision (DSM IV-TR, 2000)
Among the topics to be covered in the workshop will be: assessment and diagnostic criteria; concomitant
psychological problems; treatment planning using Freeman's Diagnostic Profile System; issues of non-
compliance with therapeutic regimen; treatment success and failure, and therapist response. Assessment
and treatment will be illustrated through the use of videotaped examples. Of special interest will be
Freeman's revision of the widely used Stages of Change developed by Prochaska & DiClemente.
Substance use or misuse that is often a primary factor or an aggravating factor of underlying personality
difficulty. Differentiation of personality disorder and substance misuse that adversely affect the person’s
ability to participate in or profit from therapy will be reviewed. Specifically, substance misusing individuals
may exhibit cognitive impairment, increased impulsivity, increased irritability, decreased problem solving
ability and difficulty concentrating. They may also exhibit irritability, exaggerated startle response,
hypervigilance, depression and withdrawal, difficulty sleeping and trusting others. In addition, 0rganic factors
such as brain damage caused by long term substance use directly impact the individual’s ability to respond
to therapy. These behaviors can be easily confused with personality disorders, and when co-mingled,
increase the complexity of treatment. It is highly likely that a significant number of persons seeking treatment
have co-existing personality disorders, co-existing substance misuse disorders, or both. Teaching
techniques will include didactic presentation and videotapes of patients with personality disorder.
Workshop Objectives
At the conclusion of this workshop, participants will be able to:
* Identify and describe the steps required to develop a Cognitive Behavioral treatment conceptualization
for treating patients with personality disorders
* Use the Diagnostic Profiling System (DPS) to gather data and direct the therapy plan
* Define four areas of impediment to therapeutic progress
* Describe substance misusing presentations that may be mistaken for personality disorder
* Explain the importance of conducting routine substance use screening with patients who exhibit
personality disorder presentation
* Describe the rationale for using cognitive and behavioral interventions
* Identify five cognitive interventions for treating patients with personality disorders
* Identify five behavioral interventions for treating patients personality disorders
* Identify the steps in Freeman's revision of the Stages of Change
* Compare and contrast symptoms of personality disorders and substance misuse.
* Describe a treatment model for treating the co-morbidity.
•About the relevant theory, assessment techniques (including the newly developed Diagnostic Profiling
System), and general treatment considerations;
•About the conceptualisation and treatment strategies for each of the three clusters of personality disorders
described by DSM-IV;
•How to differentiate between Personality Disorders and Substance Misuse Disorders
•About issues of noncompliance or impediments to the therapeutic regimen, along with techniques for
increasing compliance and collaboration; and
•About therapeutic alliance, which will be highlighted as essential for the treatment of this patient group.
Modification of the basic cognitive therapy format will be discussed and illustrated through the use of clinical
vignettes and videotape. The therapeutic goals of schematic reconstruction, schematic modification,
schematic reinterpretation, and schematic camouflage will be discussed.
Recommended Readings: Beck, A.T., Freeman, A., Davis, D. & Associates (2005). Cognitive therapy of
personality disorders, 2nd Ed. New York: Guildford Press. Layden, M.A., Newman, C.F., Freeman, A., &
Byers-Morse, S. (1993) Cognitive therapy for borderline personality disorder: Needham, MA:Allyn and
Bacon. (1995)
WORKSHOP #2:
Treatment of Patients with Narcissistic Personality Disorder
The patients with Narcissistic Personality Disorder (NPD), are often among the most difficult in the therapist's
caseload. They may require more time in therapy and greater therapist energy than other patients while
making less progress or change. They usually enter therapy for issues other than the NPD, notably
depression and anxiety or at the demand of others. Progress with these clients may be slowed or stopped by
the personality problems. These patients can become the individuals that therapists “love to hate,” in that
they frequently arouse intense negative countertransference. Often misunderstood or poorly conceptualized,
NPD will be discussed through the lenses of several theoretical models.
This workshop will briefly review the theoretical, conceptual, and developmental issues in the etiology and
treatment of NPD described in the Diagnostic and Statistical Manual, 4th Edition-Text Revision (DSM IV-TR,
2000)
Among the topics to be covered in the workshop will be: assessment and diagnostic criteria; concomitant
psychological problems; treatment planning using Freeman's Diagnostic Profile System; issues of non-
compliance with therapeutic regimen; treatment success and failure, and therapist response. Assessment
and treatment will be illustrated through the use of videotaped examples. Of special interest will be
Freeman's revision of the widely used Stages of Change developed by Prochaska & DiClemente.
Teaching techniques will include didactic presentation and videotapes of patients with NPD.
Workshop Objectives
At the conclusion of this workshop, participants will be able to:
• Identify and describe the steps required to develop a Cognitive Behavioral treatment conceptualization
for treating patients with NPD
• Use the Diagnostic Profiling System (DPS) to gather data and direct the therapy plan
• Define four areas of impediment to therapeutic progress
• Describe the rationale for using cognitive and behavioral interventions
• Identify five cognitive interventions for treating patients with NPD
• Identify five behavioral interventions for treating patients NPD
• Identify the steps in Freeman's revision of the Stages of Change.
| SymforaTapes: Master Clinicians at Work Includes CD of interview of "Alfred", Patient with Narcissistic Personality Disorder Click here for link: Symfora |
