Borderline, Narcissistic, Antisocial and Histrionic Personality Disorders: Effective Treatments for Challenging Clients

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All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners.  For speaker disclosures, please see the faculty biography.

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Speaker

Gregory Lester, PhD Related seminars and products

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Gregory W. Lester, Ph.D., is a clinical, consulting, and research psychologist with practices in Colorado and Texas. Dr. Lester has presented over 2,000 personality disorders trainings to over 200,000 professionals in every major city in the United States, Canada, and Australia. In his nearly 40 years of clinical practice, Dr. Lester has treated over 1,000 personality disorder cases and has performed psychological evaluations on over 2,500 individuals.

Dr. Lester has served on the graduate faculty of The University of St. Thomas and as a special consultant to The United States Department of Justice. Dr. Lester’s office served as one of the original research sites for the DSM-5® revision of the personality disorders section where he collaborated with Emory University, the New York State Psychiatric Group, The University of Missouri, The University of Kentucky, and the late Dr. Robert Spitzer, chairman of the DSM-3 committee.

Dr. Lester is a member of the American Psychological Association, the Texas Psychological Association, and the Colorado Psychological Association. He is the author of nine books, including Power with People, a manual of interpersonal effectiveness, Shrunken Heads, an irreverent memoir of his graduate school training, and Diagnosis, Treatment, and Management of Personality Disorders, which is the largest-selling front-line clinical manual on diagnosing, treating, and managing personality disorders.

Dr. Lester’s research and articles have appeared in publications including The Journal of the American Medical Association, The Western Journal of Medicine, The Yearbook of Family Practice, The Journal of Behavioral Therapy, The Journal of Marriage and Family Therapy, The Handbook of Depression, Transactional Analysis Journal, Living Word Magazine, The Priest Magazine, and The Houston Lawyer.

 

Speaker Disclosures:
Financial: Dr. Gregory Lester maintains a private practice. He is a consultant for Improvement Research Group. He is a published author and receives royalties. Dr. Lester receives a speaking honorarium, recording royalties, and a consulting fee from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Gregory Lester is a member of the American Psychological Association, the Texas Psychological Association, and Colorado Psychological Association.

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Objectives

1. Determine how the changes with the DSM-5® impacts diagnosis and treatment of the Cluster B Personality Disorders.
2. Diagnose clients with antisocial, narcissistic, histrionic and borderline Personality Disorders to effectively inform your choice of treatment interventions.
3. Utilize case studies to differentiate symptom overlap, effective treatment and emotional management of each Cluster B Personality Disorders client type.
4. Manage the manipulative and potentially violent behaviours with your clients diagnosed with Antisocial Personality Disorder in session to make therapeutic progress.
5. Demonstrate CBT techniques to clarify behaviours, values and goals with clients diagnosed with Narcissistic Personality Disorder.
6. Integrate techniques to decrease explosive emotions, self-harm tendencies and cravings for chaos for clients diagnosed with Borderline Personality Disorder.
7. Utilize MI and DBT techniques with clients diagnosed with Histrionic Personality Disorder to help manage cognition and improve emotional regulation.

Outline

• Updates to DSM-5® and future changes
• The real purpose of diagnosis
• Treatment errors and misdiagnosis
• Core vs. surface structures
• Four central components to diagnosis

• Understanding psychopathology
• Developmental progress in childhood
• Oppositional defiance
• Attachment and family of origin
• Primary defences and affects
• Importance of personal power
• Managing in-session violence
• Suicide attempts and threats
• Blockades – manipulation and power struggles
• Risk analysis to self and other
• Interpersonal theory techniques
• Transference and countertransference
• Lessen destructive behaviours
• Cognitive-behavioral techniques
• Psychopharmacology and applicability
• Case studies and treatment exercises
• Differential diagnoses

• Symptom presentation along the spectrum
• Attachment and family backgrounds
• Feeling identification and behavioural control
• Manage rage, boundaries, self-mutilation and suicidality
• Facilitate pattern recognition, create stability, and build therapeutic collaboration
• Develop true sense of self and lessen maladaptive need for attention
• Underlying wishes and fears
• Build DBT core mindfulness skills
• DBT techniques to dissolve distraction, calm interpersonal upheavals, and focus on the “genuine relationship”
• DBT emotion regulation skills
• Psychopharmacology and applicability
• Case studies and treatment exercises
• Differential diagnoses

• Narcissism and environmental contexts
• Attachment and family backgrounds
• Primary defences and affects
• Tackle the veneer of perfectionism
• Blockades – power struggles, empathy and criticism
• The narcissistic/borderline client
• Interpersonal strategies for empathy
• CBT techniques to clarify behaviours, values and goals
• Tactics to avoid arguing
• Motivational interviewing to overcome resistance
• Prevent sabotage
• Build a sense of true self
• Psychopharmacology and applicability
• Case studies and treatment exercises
• Differential diagnoses

• Moody to excited to flamboyant: the erratic client
• Attachment and family backgrounds
• Primary defences and affects
• Coquettish behaviour, avoidance drama, inauthenticity
• Dangers of the histrionic client
• Link between emotions and behaviour
• Interpersonal strategies for expression of true self
• Enhance sense of self and lessen the “spotlight”
• Motivational interviewing techniques
• DBT techniques
• Interpersonal strategies for positive relationships
• Strengthen self-initiative and independent action
• Psychopharmacology and applicability
• Case studies and treatment exercises
• Differential diagnoses

Target Audience

• Counsellors
• Social Workers
• Psychologists
• Psychotherapists
• Therapists
• Addiction Counsellors
• Marriage and Family Therapists
• Case Managers
• Nurses
• Physicians
• Other Mental Health Professionals

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