Richard Sears – CBT for Cluster B Personality Disorders: Techniques and Strategies You Need to Know

Outline

What You Need to Know about Cluster B Diagnoses and Approaches

• Diagnostic criteria: borderline, antisocial, histrionic, narcissistic personality disorders
• Key features of each disorder – differential diagnosis considerations
• Top indicators of PD you won’t find in the DSM-5®
• 5 things you probably never knew about cluster B personality disorders
• How to avoid judgment and labeling and its importance

CBT Treatment Strategies and Techniques for Cluster B – Your Guide to Practical Application

Behavior – How to Approach Maladaptive Behavior, Self-Sabotage, Manipulation and Attention Seeking

• How to shift behaviors that have been conditioned over a lifetime
• Disrupting reinforcement
• 5 things you may be doing that actually reinforces maladaptive behavior
• Practical application of classical and operant conditioning concepts
• Roots of behavioral therapy
  • Psychoeducation: Increase clients’ insight into how their behavior is reinforced
  • Exposure techniques: Build distress tolerance and momentum toward healthier choices
  • Chain analysis: How to address a client’s feelings of hopelessness, improve awareness and identify precipitating factors and choice points
• Case study – Sam, The Man Who Blames Everyone Else

Cognitive – How to Recognize and Interrupt Unhealthy Thinking Patterns

• How to address negative beliefs about treatment, the experience of negative emotion and getting better
• How to adapt cognitive techniques specifically for Cluster B
  • ABC records and Challenging Beliefs Worksheets
  • Socratic dialogue
  • Common cognitive distortions
• Why challenging your client’s thoughts can make things worse
• Case study – Martha, The Woman Who Confused her Thoughts and Memories with Reality

Mindfulness and Acceptance – Break Free of Distressing Thoughts, Feelings and Behaviors

• How to increase psychological flexibility, decrease emotional intensity, and focus on the bigger picture
• Why mindfulness and relaxation are not the same thing
• Mistakes with mindfulness – inadvertently encouraging avoidance
• How to adapt mindfulness and acceptance techniques for Cluster B
  • Cognitive defusion: Stepping back from thoughts
  • Acceptance: Letting go of control
  • Mindfulness: Foster the ability to stay present
  • Observing the self: Develop a bigger sense of who you are
  • Identify values: Finding the “why”
  • Take committed action
• Case study – Arthur, the Loving, Self-Centered Father

Special Clinical Considerations for Personality Disorder Practitioners

• Crisis management: Suicidal ideation/gestures, self-injury
• Create a clear crisis management plan to keep clients safe and avoid personal liability
• What you need to avoid – documentation considerations and more
• 5 signs you need to check your boundaries
• Preventative measures – to avoid boundary violations and false reporting to licensure board
• Strategies for recognizing and addressing countertransference – being honest without getting lost
• Top 3 tips for staying present in session
  • Balance boundaries with compassion
  • Model presence with distress, not joining the emotional chaos
  • Internal messages – Not getting sucked in
• Exercise: People that bother me