Metacognitive interpersonal therapy for personality disorders: A Treatment Manual PDF
Preview Metacognitive interpersonal therapy for personality disorders: A Treatment Manual
Metacognitive Interpersonal Therapy for Personality Disorders Patients with personality disorders need targeted treatments which are able to deal with the specifi c aspects of the core pathology and to tackle the challenges they present to the treatment clinicians. Such patients, however, are often diffi cult to engage, are prone to ruptures in the therapeutic alliance and have diffi culty adhering to a manualised treatment. G iancarlo Dimaggio, Antonella Montano, Raffaele Popolo and Giampaolo Salvatore aim to change this, and have developed a practical and systematic manual for the clinician using metacognitive interpersonal therapy (MIT) and including detailed procedures for dealing with a range of personality disorders. The book is divided into two parts, Pathology, and Treatment, and provides precise instructions on how to move from the basic steps of forming an alliance, drafting a therapy contract and promoting self-refl ections to the more advanced steps of promoting change and helping the patient move toward health and adaptation. W ith clinical examples, summaries of therapies and excerpts of session tran- scripts, M etacognitive Interpersonal Therapy for Personality Disorders will be welcomed by psychotherapists, clinical psychologists and other mental health professionals involved in the treatment of personality disorders. Giancarlo Dimaggio is a co-founding member of the Center for Metacognitive Interpersonal Therapy. He is the author of four books and numerous articles. Antonella Montano is a founding member and director of the psychotherapy school at A. T. Beck Institute for Cognitive Behavior Therapy. He is a teacher and supervisor of the Associazione Italiana Analisi e Modifi cazione del Comportamento (AIAMC), a certifi ed trainer/consultant/speaker/supervisor of the Academy of Cognitive Therapy (ACT), a member of the International Association for Cognitive Psychotherapy (IACP) and a member of the International Society for Sexual Medicine (ISSM). Raffaele Popolo is a co-founding member of the Center for Metacognitive Interpersonal Therapy, a trainer at the Società Italiana di Terapia Comportamentale e Cognitiva (SITCC) and a trainer of the psychotherapy school ‘Studi Cognitivi’. He has written papers on psychopathology and the treatment of personality disorders and psychosis. Giampaolo Salvatore is a co-founding member of the Center for Metacognitive Interpersonal Therapy, a trainer at A. T. Beck Institute for Cognitive Behavior Therapy. He has written papers about the psychotherapeutic process and the pathology and treatment of schizophrenia and personality disorders, and in particular of persons with paranoid features. Metacognitive Interpersonal Therapy for Personality Disorders A treatment manual Giancarlo Dimaggio, Antonella Montano, Raffaele Popolo and Giampaolo Salvatore First published 2015 by Routledge 27 Church Road, Hove, East Sussex, BN3 2FA and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2015 Giancarlo Dimaggio, Antonella Montano, Raffaele Popolo and Giampaolo Salvatore The right of Giancarlo Dimaggio, Antonella Montano, Raffaele Popolo and Giampaolo Salvatore to be identifi ed as authors of this work has been asserted by them in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice : Product or corporate names may be trademarks or registered trademarks, and are used only for identifi cation and explanation without intent to infringe. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data Dimaggio, Giancarlo, author. [Terapia metacognitiva interpersonale per i disturbi di personalit?. English] Metacognitive interpersonal therapy for personality disorders : a treatment manual / Giancarlo Dimaggio, Antonella Montano, Raffaele Popolo, and Giampaolo Salvatore. pages cm 1. Personality disorders–Treatment. 2. Metacognition. I. Montano, Antonella, author. II. Popolo, Raffaele, author. III. Salvatore, Giampaolo, author. IV. Title. RC455.4.B5D5613 2015 616.85’81–dc23 2014033799 ISBN: 978-1-138-02415-1 (hbk) ISBN: 978-1-138-02418-2 (pbk) ISBN: 978-1-315-74412-4 (ebk) Typeset in Times by Deer Park Productions Contents List of abbreviations vii Introduction ix 1 Personality disorder psychopathology: form and contents of subjective experience 1 2 Personality disorder psychopathology: functions 33 3 Assessment and case formulation in metacognitive interpersonal therapy 52 4 Step-by-step formalised procedures 65 5 Therapeutic relationship 74 6 Shared formulation of functioning: enriching autobiographical memory, improving access to inner states and reconstructing schemas 103 7 Promoting differentiation 123 8 Construction of new self-aspects: access to self-parts, exploration, increase in agency, overcoming avoidances 142 vi Contents 9 Promoting the understanding of the other’s mind and integration 160 10 Treating symptoms and promoting mastery of relational problems 185 11 Comparison of metacognitive interpersonal therapy and cognitive behavioural therapies 217 Appendix: Diagnostic instruments usually adopted in MIT 231 References 243 Index 261 A bbreviations ABC antecedent, belief, consequence ACT acceptance and commitment therapy APA American Psychiatric Association A-PST Advanced Picture Sequencing Task ATT attentional training BDI Beck Depression Inventory BLERT Bell-Lysaker Emotional Recognition Task BVAQ Bermond-Vorst Alexithymia Questionnaire CAS cognitive attentional syndrome CBT cognitive behavioural therapy CBT-E enhanced transdiagnostic CBT for eating disorders CCRT core confl ictual relational theme DBT dialectical-behaviour therapy DERS Diffi culties in Emotion Regulation Scale EIS Emotional Inhibition Scale ERP exposure and response prevention ERQ Emotion Regulation Questionnaire IIP Inventory of Interpersonal Problems MAI Metacognition Assessment Interview MAS-R Metacognition Assessment Scale – Revised MBSR mindfulness-based stress reduction MCMI Millon Clinical Multiaxial Inventory MCT metacognitive therapy MIT metacognitive interpersonal therapy MOSST Metacognitive Oriented Social Skills Training MSCEIT Mayer-Salovey-Caruso Emotional Intelligence Test PD personality disorder PDNOS personality disorder not otherwise specifi ed SCL Symptom Checklist STAI State-Trait Anxiety Inventory viii Abbreviations TAS Toronto Alexithymia Scale ToM theory of mind TR thought recording TZPD Therapeutic Zone of Proximal Development YSQ Young Schema Questionnaire Introduction Time was ripe. Psychotherapies for personality disorders (PDs) have undergone a major leap during the last twenty years. We know better their self-sustaining mechanisms, that they respond to treatment (unlike the pessimism of some decades ago) and that drop-out can be kept to a reasonably low amount. But it is a patchy evolution. The majority of progress was made with borderline PD, for which many treatments of proven effectiveness exist and are currently under refi nement and further empirical testing. For all the other PDs, except avoidant and narcissistic, the literature is scanty and fragmented. The clinician wanting to treat dependent, paranoid, obsessive-compulsive PD or depressive, passive- aggressive and schizoid traits, has to dig hard to fi nd a well full of water. The bias towards borderline PD is unjustifi ed, as the other PDs are overall much more prevalent and can be just as severe as the former. There is another problem. Many patients do not present with pure disorder. Co-occurrence among PDs or of a PD with traits of other disorders is the rule more than the exception. Knowing how to treat a patient with narcissism is one matter. A totally different matter is treating a patient with narcissism and obsessive- compulsive, paranoid and passive-aggressive traits. Leaving specifi c orientations aside, we thought a guide for the clinician treating these conditions was lacking. For this reason, this volume deals with the PDs listed above, taking into account their occurrence. Borderline PD is not discussed here. It was about fi lling a gap. W e chose to describe common procedures across different PDs, without devot- ing specifi c chapters to the various disorders. We designed precise sequences of interventions that can be applied to any kind of personality features the patient presents with. Leaving the diagnosis aside, we think the best way to understand a PD in a way that makes treatment planning easier is a carefully devised case formulation. Needless to say, diagnosing a specifi c PD is relevant for treatment planning and the model of pathology described in our previous manual are still valid (Dimaggio, Semerari, Carcione et al., 2007 ). O ur focus here has been on showing how to make an extremely careful case formulation. The aim is for both clinician and patient to have a map of the patient’s mental functioning. This allows for optimisation of therapy work, moving step-by- step towards healing personality problems and alleviating symptoms.
The list of books you might like
