Causes of Personality Disorderso The exact cause of personality disorders is unknowno Evidence points to both genetic AND environmental factors such as history of

personality disorders in the familyo Some experts believe that traumatic events occurring in early childhood exert a crucial

influence on behaviour later in lifeo Some propose that people are genetically predisposed to personality disorders or that

they have an underlying biological disturbance (anatomical, electrical, or neurochemical)

Symptoms vary widely depending on the specific type of personality disorderHowever, individuals with personality disorders have most of the following in common:

1. Self-centeredness that manifests itself through a “me-first” attitude2. Lack of individual accountability that results in a “victim mentality” and blaming others

for their problems3. Lack of empathy or caring4. Manipulative and exploitive behaviour5. Unhappiness, suffering from depression, and other mood or anxiety disorders6. Vulnerability to other mental disorders7. Distorted or superficial understanding of self and others’ perceptions that result in being

unable to see how objectionable, unacceptable, and disagreeable their behaviour is8. Self-destructive behaviour9. Socially maladaptive, changing the ‘rules of the game”, or otherwise influencing the

external world to conform to their own needs

Treatment of Personality Disordero The first goal of treatment is the relief of anxiety, depression, and other distressing

symptoms (if present)o Reducing environmental stress can also quickly relieve symptomso Personality traits take many years to develop, and treatment of maladaptive traits may

take many years as well.o No short term treatment can cure a personality disorder, although some changes may

be accomplished faster than otherso Behaviour changes can occur within a year, interpersonal changes can take longero Although treatments differ according to the type of personality disorder, some general

principles apply to all treatments

o Because people with a personality disorder do not see a problem with their own behaviour, they must be confronted with the harmful consequences of their maladaptive thoughts and behaviours.

What is the CYW’s Role in Treatment? The CYW to repeatedly point out the undesirable consequences of their thoughts and

behaviour patterns. (“How is that working out for you?”) Sometimes the CYW finds it necessary to set limits on behaviour (for example,

adolescents may be told that they cannot raise their voice in anger). The involvement of family members is helpful and often essential because they can act

in a way that either reinforces or diminishes the problematic behaviour or thoughts. The CYW involved in treatment strategies for personality disorder clients should have a

clear understanding of the client’s areas of emotional sensitivity and usual ways of coping

The CYW must develop a cooperative relationship with their client, enabling them to begin to understand the source of their distress and recognize their maladaptive behaviour

Types of Therapy used in Treatment

Psychotherapy o Psychotherapy can help clients more clearly recognize the attitudes and behaviours that

lead to interpersonal problems, such as dependency, arrogance and manipulativenesso This is the main way to treat personality disorders.o Clients learn healthy ways to manage symptoms and reduce behaviours that interfere

with functioning and relationships

Cognitive Behaviour Therapy (CBT)o CBT is focused on improving moods and behaviour by examining confused or distorted

patterns of thinkingo The clients learns that thoughts, feelings and moods can influence their behaviour For example, if a child has problematic behaviour patterns, the therapist seeks to

identify the underlying thinking that causes them. The facilities the child`s replacement of this thinking with thoughts that results in more appropriate feelings and behaviours.

Dialectical Behaviour Therapy (DBT)o DBT is used to treat older adolescents with suicidal thoughts, who intentionally engage

in self-destructive behaviour or who have borderline personality disorder o DBT teaches how to take responsibility for one`s problems and how to deal with conflict

and negative feelings

o Teaches problem solving and helps to change unhelpful behaviourso DBT often involves a combination of group and individual sessions

Family Therapyo This therapy approach is designed to help the family unit function in more positive and

constructive ways by exploring patterns of communication and providing support and education.

o Helps family members develop skills to better understand and support a relative with a personality disorder.

o Family therapy session can include the child or adolescent along with parents and siblings.

Group Therapyo Group therapy uses group dynamics and peer interactions to increase understanding,

communication, and improve social skills.o May help teach people how to interact with others and how to express themselves

effectively

Play Therapyo Play therapy is directed at helping younger children. It involves the use of toys, blocks,

dolls, puppets, drawings, and games to help the child recognize, identify, and verbalize feelings

o The therapist observes how the child uses play materials and identifies themes or patters to understand the child’s problems.

o Through a combination of talk and play, the child has an opportunity to better understand conflicts, feelings and behaviour.