Clients with cluster B personality disorders (borderline, antisocial, histrionic, and narcissistic) can be amongst the most challenging for therapists. Clinicians who are not properly trained can inadvertently make clients worse, and can even put themselves at risk for licensure board complaints.
However, when equipped with a deeper understanding of these disorders and the most effective principles and techniques, it can be extremely rewarding to witness the positive ripple effects that occur in these clients and their families.
In this recording, join clinical psychologist and author Dr. Richard Sears for a compassionate yet direct approach for working with these individuals using cutting edge, practical interventions that are grounded in theory.
- How even the most frustrating, maladaptive behaviours get conditioned and reinforced over time (and what to do about it)
- How to recognize and interrupt unhealthy thinking patterns
- Strategies for breaking free of struggles with thoughts, feelings, and unhealthy behaviours
- Skills for managing stress, pointers for managing stressful sessions, etc.
- How to avoid getting “sucked in” or hooked into the drama, “crisis of the week”
- How to model presence with distress and emotional chaos
With solid principles and detailed case examples, Dr. Sears will bring these concepts and methods to life with passion and humour, giving you practical take-aways to use in your very next therapy session!
Center for Clinical Mindfulness and Meditation
Richard W. Sears, PsyD, PhD, MBA, ABPP, has given hundreds of workshops on and ACT all around the world. He is a board-certified clinical psychologist in Cincinnati, Ohio, where he runs a private therapy and consultation practice, and is Director of the Center for Clinical Mindfulness & Meditation. He holds several academic appointments, including the Department of Clinical Psychiatry & Behavioral Neurosciences with the UC College of Medicine. Dr. Sears is also a psychologist contractor with the Cincinnati VA Medical Center and with Alliance Integrative Medicine.
Dr. Sears is author of over a dozen books, including ACT with Anxiety; The CBT & Mindfulness Toolbox and Mindfulness: Living Through Challenges and Enriching Your Life. He is also a sixth-degree black belt in Ninjutsu, and once served as a personal protection agent for the Dalai Lama of Tibet. He has a PhD in Buddhist Studies, and received ordination in three traditions, as well as recognition as a Zen master.
Financial: Dr. Richard Sears maintains a private practice and has an employment relationship with the University of Cincinnati, Alliance Integrative Medicine, and Wright State University School of Professional Psychology. Dr. Sears receives royalties as a published author. He receives a speaking honorarium, recording royalties, and book royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Richard Sears is the director of the Center for Clinical Mindfulness and Meditation. He has professional affiliations with the American Board of Professional Psychology, the Academy of the American Board of Clinical Psychology, the Association for Contextual Behavioral Sciences, and the Cincinnati Academy of Professional Psychology.
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- Differentiate diagnostically between the four Cluster B personality disorders to accurately inform the treatment planning process.
- Utilize treatment interventions based in cognitive and behavioral approaches, including exposure, chain analysis. ABC records and challenging distortions, for clients diagnosed with personality disorders.
- Determine and address potential clinical issues including crisis management, countertransference, boundary setting and self-care.
- Implement mindfulness-based interventions to increase clients’ psychological flexibility and decrease emotional intensity.
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
- Social Workers
- Addiction Counselors
- Marriage and Family Therapists
- Case Managers
- Other Mental Health Professionals