Mastering Challenges in Case Management:
|
|
- Oswin Harris
- 5 years ago
- Views:
Transcription
1 Mastering Challenges in Case Management: Working with Clients Who Have Personality Disorders Presented by Kate Harri, MA, LP Working Solutions, LLC September 2014
2 Outline Know the six most common Personality Disorders Understand what "causes the development of these disorders Learn the best practice treatment for these conditions Enhance claim management skills to join with and work successfully with individuals who have these diagnoses impacting function
3 Characteristics Common in Personality Disorders Behaviors that are problematic are developed in late adolescence or early adulthood Behaviors are life-long and resistant to change Medications are generally ineffective The individual blames others for the problems that arise; they are unaware of their poor coping skills The behaviors result in significant disruption in the individual s personal and work life. Some behaviors can be life threatening.
4 Characteristics Continued The individual is fragile Over-reacts to normal life events and stressors Regresses easily Once regresses, challenging to get back to baseline If in treatment, any added stressor can become the focus of treatment due to the over-reaction of the patient, thus delaying recovery.
5 The Six Most Common Disorders Antisocial PD: Males 5.8% of population; females 1.2% Borderline PD: 5.9% of population (75% are female) Dependent PD: 0.5% of population (equal in males and females) Histrionic PD: 1-3% of population (females 4x more likely) Narcissistic PD:1% of PD (more prevalent in males) Obsessive Compulsive PD: 1% of population (twice as common in males) Overall prevalence of PD in the general population is 9%. -NIMH 2007
6 One Key Factor to Consider Most providers do not identify the presence of any personality disorder as part of their assessment due to stigma, or misdiagnosing Research information gathered by Pam Warren, PhD in 2009 on assessment in worker s compensation claims revealed:22% of cases had adequate evaluation, 48%, superficial, and 30% had no evaluation What does this suggest about potential accuracy of diagnosis and treatment impact?
7 Getting Stuck: Impact of All Personality Disorders Personality disorders are conditions in which people have traits that cause them to feel and behave in socially distressing ways, limiting their ability to function in relationships and in other areas of their life, such as work or school.
8 Getting Stuck What if There is More Than Just A Personality Disorder Present? Impact of personality disorder on an individual s life Impact of psychosocial stressors Impact of physical condition Impact of existing mood disorder (sub-acute) Impact of existing mood disorder (diagnosed and treating for it) Over time, all conditions get worse if not addressed and treated appropriately
9 It s Not Hopeless; It s About Knowing What to Look for And What to Do Know the diagnosis Know best practice treatment Be on the lookout for the possibility of the presence of personality disorder Be mindful of the presence of psychosocial stressors Know how to talk with patients and providers
10 The Slightly Sullied Six Diagnoses Possibly caused by Early childhood trauma (sexual or physical abuse) resulting in attachment issues (relationship problems, distortions) Pampering or neglect by adults Genetics Verbal abuse Inconsistent and unpredictable parenting Peers Negative relationship with an adult -American Psychological Association
11 Diagnosing PD Thoughts and behaviors deviate from accepted norms: Cognitive distortions Affect (labile or not appropriate to situation) Control over impulses and self-gratification lacking Poor interpersonal skills
12 Diagnosing PD The deviations are INFLEXIBLE/RIGID Maladaptive Dysfunctional across a wide range of work, personal situations
13 Diagnosing PD The deviations are LONG STANDING STABLE (enduring) Start in late adolescence or early adulthood
14 Diagnosing PD The deviations do not have another explanation such as another mental health condition or use of a substance Providers should eliminate organic brain disease, injury or dysfunction as a possible cause of the deviation
15 Fun Facts to Know and Tell A study at the University of Surrey, UK, indicated three personality disorders were more common in executives than criminals Histrionic Narcissistic Obsessive Compulsive Board, Belinda Jane; Fritzon, Katrina; Disturbed Personalities at Work, Psychology, Crime and Law, 2005.
16 The Recipe for Developing a Personality Disorder It is a disturbance of attachment Can be caused by unhealthy treatment of the child by an adult Sexual abuse Physical abuse Significant neglect Overprotective or authoritarian
17 Borderline Personality Disorder Diagnosis A pervasive pattern of instability of interpersonal relationships, self-image and affect. Marked impulsivity that begins by late adolescence or early adulthood and is present in a variety of contexts. NOTE: it is frequently mistaken for other conditions Bipolar Disorder Depression Anxiety Substance abuse/dependence
18 Borderline PD Cont. Often has mood disorder present as a secondary condition but is noted by provider as primary condition Must be very carefully assessed for accurate diagnosis!
19 Borderline PD Diagnosis Cont. Indicated by 5 or more of the following: Frantic efforts to avoid real or imagined abandonment Patterns of unstable and intense personal relationships (extremes of idealization/devaluation) Markedly and persistently unstable self-image Impulsivity in at least two areas that are potentially self-damaging such as spending, sex, substance abuse, reckless driving, binge eating
20 Borderline Cont. Recurrent suicidal gestures, threats or self-mutilating behavior Unstable mood often referred to as mood lability or dysregulation Chronic feelings of emptiness Inappropriate, intense anger; difficulty controlling anger Transient, stress-related paranoid ideation or severe dissociative symptoms
21 Treatment Considerations They fear abandonment They will alternately think others are the best thing that ever happened to them or the worst (makes developing a professional relationship very challenging!) Can accidently do serious harm or cause their own death through suicidal gestures that are meant to get your attention Moving target with both feelings and behaviors VERY difficult to treat
22 Borderline PD: Effective Treatment Dialectical Behavior Therapy (DBT) is the treatment recognized to have positive results Teaches the person how to manage their feelings without acting out their anxiety or distress in maladaptive ways Intense treatment format; includes group several times a week and weekly individual therapy over several months Participants keep a daily diary of incidents; feelings; reactions-they are taught how to RESPOND rather than REACT-this is also reflected then in the diary as they practice the skills taught in group and oneon-one
23 The Antisocial Personality Disorder Indicated by 3 or more of the following: Failure to conform to social norms with respect to lawful behaviors Deceitfulness, such as repeated lying, use of aliases, conning others Impulsivity Irritability and aggression; fights and assaults
24 Antisocial Diagnosis Cont. Reckless disregard for safety of self or others Consistent irresponsibility, repeated failure to sustain consistent work behavior or to honor financial commitments Lack of remorse Person is at least 18
25 Treatment Considerations Because they don t care about you or anyone else.they are difficult to treat It s everyone else s fault I am going to do what I want to and you can t make me do anything They don t care about you, they disregard the rights and feelings of others and are self-absorbed. Your emphasis and focus has to be on what s in it for them. Realistically, you may not see many of them; they are usually spending their time in front of judges and in jail.
26 Dependent Personality Disorder Characterized by a pervasive and excessive need to be taken care of that leads to clinging and submissive behavior and fears of separation. Indicated by 5 of the following: Difficulty making everyday decisions independently Needs others to assume responsibility for most major areas of life Has difficulty expressing disagreement-fear of loss of support or approval
27 Diagnosis Cont. Difficulty initiating projects or doing things on own Goes to excessive lengths to obtain nurturing or support Feels uncomfortable being alone Urgently seeks another relationship when a close relationship ends Unrealistically preoccupied with fears of being left to take care of self
28 Treatment Considerations They don t seek treatment of their own volition; they don t see that their behavior is problematic (true of all PDs) They often develop a mood disorder (depression) secondary to the PD and may seek treatment for that Providers may miss seeing the PD and only treat the symptoms of depression NOTE: If the person is not getting better despite several medication trials, strongly suspect the PD is primary Their overall motivation will be for you to take care of them-hence, they will react strongly to any suggestion their benefits may end
29 Treatment Considerations Cont. Best treatment should be short term; especially as they can become dependent on the providers Assertiveness training teaching them how to advocate and speak for themselves Increase independent activity such as making decisions about everyday things Teach strategies on managing anxiety Expand ability to be on their own, by themselves Teach what constitutes healthy relationship and how to manage their part in having a healthy relationship as well as the benefits (that the relationship usually lasts longer)
30 Histrionic Personality Disorder Pervasive and excessive emotionality and attentionseeking behavior. Individuals feel uncomfortable or feel unappreciated when they are not the focus/center of attention. They are commonly known as the life of the party. They are the Hey Mom, Look at me! people
31 Histrionic PD Diagnosis/Differentiation Can be confused with other diagnoses Borderline PD-differentiator is that Borderline will threaten self-harm Dependent PD- differentiator is that the dependent personality is not flamboyant Narcissistic PD-won t look fragile or dependent to get attention or to get needs met
32 Histrionic PD Diagnosis Indicated by 5 or more of the following: Uncomfortable in situations where he/she is not the center of attention Interactions with others often characterized by inappropriate sexually seductive or provocative behavior Displays labile emotions Consistently uses physical appearance to draw attention to themselves
33 Diagnosis Cont. Style of speech lacks details or is overly impressionistic Shows self-dramatization, theatricality and exaggerated expression of emotion Is suggestible (easily influenced) Considers relationships to be more intimate than they really are
34 Histrionic PD Treatment Considerations As the symptoms are similar to Borderline Personality Disorder Treatment that is most effective is DBT to positively impact: Poor judgment Mood lability Attention seeking with disregard for consequences to self and others
35 Narcissistic Personality Disorder Diagnosis A pervasive pattern of grandiosity, need for admiration and lack of empathy for others.
36 Narcissistic PD Diagnostic Criteria Indicated by 5 or more of the following: Grandiose sense of self-importance (exaggerates, feels superior and expects recognition) Preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love Believes they are special and unique and can only be understood by others like themselves (hard to find!) Requires excessive admiration
37 Diagnosis Cont. Sense of entitlement Exploits others for their own gain Lacks empathy Envious of others or that others envy them Arrogant, haughty behaviors and attitude prevalent
38 Narcissistic Treatment Considerations Gotta be special! If they have a physical illness, this can seriously complicate things as they see themselves as perfect and this shatters that. This can delay recovery! Demand to be treated by experts -will not accept common providers Rigid and fragile-anything can upset their day or lifeputting them into a tailspin
39 Treatment Considerations Cont. Cognitive Behavior Therapy (CBT) in a group format with one-on-one individual therapy is best. Allows them to feel special with the individual sessions Allows them to gradually get feedback from others on their destructive attitudes and behaviors CBT strategies focus on changing the irrational belief that they are special to one of appreciating their uniqueness without putting down others Medications can augment depressive symptoms if present Individual does not generally want to go to treatment as they see nothing wrong with behavior; usually forced to go by others in their life
40 Obsessive-Compulsive PD A preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness and efficiency.
41 Obsessive Compulsive PD compared to OCD The main differences between Obsessive Compulsive PD and OCD is the PD: Enjoys perfecting something They do not feel distressed during or after engaging in these behaviors They do not engage in ritualistic behaviors
42 Diagnostic Criteria Indicated by 4 or more of the following: Pre-occupied with details, rules, lists, order, organization or schedules to the extent that the major point of the activity is lost Shows perfectionism that interferes with task completion (can t get the task done because the standard they set mentally is not being met) Excessively devoted to work and productivity to the exclusion of their personal life
43 Diagnostic Criteria Cont. Over-conscientious, scrupulous and inflexible about matters of morality, ethics or values Unable to discard worn out or worthless objects regardless of value Reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things Adopts miserly spending style toward self and others; money is hoarded for the future Shows rigidity and stubbornness
44 Obsessive Compulsive PD Treatment Considerations Most effective is Cognitive Analytic Therapy (CAT) Focus on understanding patterns of behavior that are ineffective, help person recognize the patterns, understand origins and then to change them to other strategies that are more effective in meeting life and work goals. If CAT is not available, CBT is also recognized to be most effective Therapy is short term; average is 16 weeks This disorder does respond to antidepressant medication; Prozac is recommended Need assistance in managing feelings of depression and anxiety as they change BONUS: this PD tends not to abuse chemicals (due to rigidity/morals)
45 SO.What is Best for You to Do in Managing These Types of Individuals? Don t panic! Keep your perspective intact Remember you are not crazy (someone with a PD can make you feel that you are ) STAY CALM and STAY THE COURSE Get support from colleagues as needed!
46 Communication with the Dependent Personality Disorder They want to cling -you may need to clarify your role as many times as needed They are afraid they can t make the goals set; celebrate small steps and keep them focused on the next small step They could suck you dry; set limits on the time you spend with them! Set clear boundaries and stick to them They fear rejection and will call you and call you and call you anticipate this and call them first Do what you say you will do; be consistent (to a fault)
47 Communication with the Borderline Personality Disorder They tend to overreact to EVERYTHING; remain cool, calm and collected They look for signs you don t care about them; be consistent and reassure as needed DO NOT make a promise you can t keep DO NOT react Overall, no matter what they do, be there for them-being cool, calm and consistent Stay the course; be supportive, encouraging as well as staying focused on the goals
48 Communication with the Narcissistic Personality Disorder They are special and expect to be treated by experts!-let them know they are working with you-the BEST in the business They have fragile egos; be respectful and have lots of patience with their resistance/reluctance They are sensitive to criticism; be sure you are on solid ground with them before introducing anything that could be seen as being critical of them Find ways to compliment-be genuine As they are so special and unique, let them know the work you do with them is personalized!
49 Communication with the Antisocial Personality Disorder They are similar to the narcissistic PD; very sensitive to criticism so- BE SURE TO BE ACCEPTING without MORALIZING They have a value system that is disturbing to us; monitor your own reactions and feelings so you don t have an attitude when communicating with them They are all about themselves; no one else matters-so be sure you focus everything on THEM and what s in it for THEM They do not care about others; again, keep in mind what resonates is What s in it for me? If they see there is something in the Deal for them, they will participate.
50 Communication with the Histrionic Personality Disorder They are similar to Borderline PD Be clear Be calm Be consistent Stay focused; do not go on their emotional roller coaster with them Keep boundaries clear and consistent Let them know something they did well each time you talk
51 Communication with the Obsessive Compulsive Personality Disorder They will want to do things perfectly or not at all Stay focused on the goals in a way they see a small success is GREAT! As they accomplish things, give them positive feedback Reinforce that doing things ok is good enough; that is best-rather than trying to get it just right.
52 Summary of Strategies with all Personality Disorders Calm Consistent Follow up and follow through Celebrate small successes Stay off the emotional roller coaster If you get frustrated, talk to a colleague! Vent with them rather than with the claimant Be non-judgmental
53 Because They fear rejection They don t think they ever do anything wrong; everyone else does Not much works to improve their condition easily (they can t take a pill for their personality) They are reactive and wonder why everyone around them is going nuts They have poor judgment They have distorted thinking that leads to the inappropriate behaviors
54 Now A Note About Psychosocial Stressors- Here are Common Ones Work Family Financial Health Childcare Eldercare Legal Marital/Partner Loss of Loved One
55 Psychosocial Stressors Normal Everyone has them What are yours? Usually present with Personality Disorder They create them They overreact to ones that are present
56 Psychosocial Stressors- Stuff Happens Incident happens (divorce, assault, robbery, death in family etc.) It complicates recovery Distracts treating providers from the main focus Can actually derail treatment or interrupt progress
57 What About Being Off Work Due to Diagnoses? Providers (and case managers) are tempted to avoid talking about work Work stress probably had something to do with the patient being off work Hard to bring it up for discussionoverreaction/disengagement possible
58 Why is Return to Work Important? TIME IS TICKING Journal of Occupational Medicine in 2003 stated If someone is off work 3 months; chance they will RTW If someone is off work 6 months; 20% chance they will RTW American Psychiatric Association in 2005 stated Being off work is a crisis All resources need to be utilized to aid in recovery Work is therapeutic
59 Being Off Work Can Be Dangerous To Your Health Workplace absence = Decreased Physical Health Decreased Mental Health Decreased Financial Health Decreased Social Support RESULTING IN 50% increase in MORTALITY -P. Warren, 2009
60 Getting Back to Work is Important How do You Talk With Providers? Do your homework Know the diagnosis Know the treatment plan Know the response to medications Know the progress to date Know the inconsistencies Know the person s current level of function (vs symptom reporting) Is return to work part of the plan by the provider?
61 The Call/Common Questions to Ask MAKE A LIST OF THE QUESTIONS YOU NEED AN ANSWER TO BEFORE THE CALL Focus your questions on level of function; not symptom reporting Ask what they have talked with the patient about regarding work and return to work Ask if they are willing to make changes to the plan (if the patient is not improving) Ask what they would need to see to indicate the patient is improving to the point either volunteer work or a trial gradual return to work could be initiated Share the research about being off work and how it impacts mental health and psychosocial issues
62 The Call/Joining with the Provider Indicate you have read the medical information and You can see this is a complicated case You can see they have been trying to change things to improve the patient s status You are concerned-and you suspect they share this concern that the patient does not seem to be showing much improvement to date Ask them what they think are the barriers present impacting recovery Ask them what would help reduce or eliminate the barriers
63 The Personality Disorder Factor If the information you have suggests there may be a PD present- or at least traits of PD present impacting the duration of the claim Ask the provider if he/she has wondered if there is a PD or traits present More often than not, they will admit it if there is- Ask then what else could be done in the treatment plan to address this and reduce the impact the PD is having on recovery Maintain your focus: getting the best treatment for recovery!
64 Summary Know the diagnosis and Look for possible PD Review the treatment to date; is it getting results? Join with patients where they are if PD is present Have your questions prepared before calling the providers Join with them Know the patient s level of function Be sure to address return to work
65 Questions? Thank you for attending today! Contact information Kate Harri, MA LP
Personality Disorders
Personality Disorders What is your personality? Personality is the combination of thoughts, emotions and behaviors that makes you unique. It's the way you view, understand and relate to the outside world,
More informationPersonality Disorders Explained
Personality Disorders Explained Personality Disorders Note: This information was taken pre-dsm-v. There are ten basically defined personality disorders. These are defined below in alphabetical order. Note:
More informationCluster A personality disorders- are characterized by odd, eccentric thinking or behavior.
Personality Disorders Personality disorders are grouped into three clusters, based on similar characteristics and symptoms. Many people with one personality disorder also have signs and symptoms of at
More informationPersonality Disorders
Personality Disorders Personality What is personality? Personality is a unique and long-term pattern of inner experience and outward behavior Tends to be consistent and is often described in terms of traits
More informationPersonality Disorders. Mark Kimsey, M.D. March 8, 2014
Personality Disorders Mark Kimsey, M.D. March 8, 2014 Objectives Understanding personality disorders using criteria from DSM-5. Learn approaches for separating personality disorders from other major illnesses.
More informationPersonality and its disorders
Personality and its disorders An individual s unique constellation of consistent behavioral traits. Durable disposition to behave in a particular way in a variety of situations. Adjectives like honest,
More informationSlide 1. Slide 2. Slide 3 Similar observations in all subsets of the disorder. Personality Disorders. General Symptoms. Chapter 9
Slide 1 Personality Disorders Chapter 9 Slide 2 General Symptoms Problems must be part of an enduring pattern of inner experience and behavior that deviates significantly from the expectations of the individual
More informationPersonality disorders. Personality disorder defined: Characteristic areas of impairment: The contributions of Theodore Millon Ph.D.
Personality disorders Personality disorder defined: An enduring maladaptive pattern of inner experience and outward behavior, involving impaired: (two or more of the following) sense of self emotional
More informationAwareness of Borderline Personality Disorder
Borderline Personality Disorder 1 Awareness of Borderline Personality Disorder Virginia Ann Smith Written Communication Sarah Noreen, Instructor November 13, 2013 Borderline Personality Disorder 2 Awareness
More informationPsychiatric Diagnoses In Developmentally Disabled Persons
Agenda Psychiatric Diagnoses In Developmentally Disabled Persons Kari L. Kennedy, PsyD, HSPP Dana Lasek, PhD, HSPP Wednesday, 10/26/2011 History and challenges Dementia Mood disorders Anxiety disorders
More informationManaging Personality Disorders in Primary Care
Managing Personality Disorders in Primary Care James A. Bourgeois, O.D., M.D. Learning Objectives At end of presentation, attendees will be able to: Classify personality disorders according to DSM-IV-TR
More informationPersonality Disorder in Primary Care. Dr Graham Ingram Consultant Psychiatrist
Personality Disorder in Primary Care Dr Graham Ingram Consultant Psychiatrist Epidemiology Prevalence 6-13 % ECA etc Primary care surgery consults 24 % (Moran) Borderline PD community 1-2 % Borderline
More informationPersonality Disorders
Personality Disorders Personality Personality Style: lifelong way of coping, manifested in how a person thinks, feels and behaves Personality Stable and predictable Flexible and adaptive We continue to
More informationPersonality disorders. Eccentric (Cluster A) Dramatic (Cluster B) Anxious(Cluster C)
Personality disorders Eccentric (Cluster A) Dramatic (Cluster B) Anxious(Cluster C) Personality Enduring pattern of perceiving, relating to and thinking about the environment and oneself in a wide range
More informationGenetic and biologic vulnerability (traits & temperament) Substance abuse
Personality CHAPTER 24 Enduring pattern of behavior (conscious and unconscious) that reflects a means of adapting to the environment and it s cultural, ethnic, and community standards Personality Disorders
More information3/9/2017. A module within the 8 hour Responding to Crisis Course. Our purpose
A module within the 8 hour Responding to Crisis Course Our purpose 1 What is mental Illness Definition of Mental Illness A syndrome characterized by clinically significant disturbance in an individual
More informationPersonality Disorders
Personality Disorders Personality Disorders Using DSM system Longstanding difficulties coded on Axis II Idea is to capture developmental concerns Often described as problems more interpersonal in nature
More informationMental Health. Borderline Personality Disorder
Mental Health Borderline Personality Disorder a) Borderline Personality Disorder b) I want to go into detail because I feel that many addicts with Complex Trauma have this i. BPD comes out of more severe
More informationApproach to the Patient with Borderline Personality Disorder in Primary Care
Approach to the Patient with Borderline Personality Disorder in Primary Care Cerrone Cohen, MD Duke University Departments of Family Medicine & Psychiatry 1 What is Borderline Personality Disorder? 1 What
More informationTraits: Prominent enduring aspects and qualities of a person.
Personality Disorders 257 Personality: The distinctive set of characteristics that defines the emotions, thoughts, perception and behavior or an individual s personal style and influence his interactions
More informationBorderline Personality Disorder. Diagnostic Features of Borderline Personality Disorder
Borderline Personality Disorder Diagnostic Features of Borderline Criterion 1 Essential feature is a pervasive pattern of instability of interpersonal relationships Self-image and affects Marked impulsivity
More informationWorking with Clients with Personality Disorders. Core Issues of All Personality Disorders. High Conflict Personality Disorders
Working with Clients with Personality Disorders AFCC Webinar July 18, 2018 Bill Eddy, LCSW, Esq. Copyright 2018 High Conflict Institute www.highconflictinstitute.com Core Issues of All Personality Disorders
More informationPost-Traumatic Stress Disorder
Post-Traumatic Stress Disorder Teena Jain 2017 Post-Traumatic Stress Disorder What is post-traumatic stress disorder, or PTSD? PTSD is a disorder that some people develop after experiencing a shocking,
More informationCan my personality be a disorder?!
Can my personality be a disorder?! Chapter 11- Personality Disorders 1 A personality refers to a distinctive set of behavior patterns that make up our individuality. Our personality consists of traits
More informationCan my personality be a disorder?!
Can my personality be a disorder?! Chapter 10- Personality Disorders What is Personality? There are many characteristics of personality: George is shy Karen is outgoing Missy is such a drama queen Jane
More informationDepression: what you should know
Depression: what you should know If you think you, or someone you know, might be suffering from depression, read on. What is depression? Depression is an illness characterized by persistent sadness and
More informationAdvocacy in Difficult Situations. AFSCME Local 88 Steward Training October 19, 2011
Advocacy in Difficult Situations AFSCME Local 88 Steward Training October 19, 2011 Types of Challenges Dealing with victims of sexual harassment or bullying Dealing with ineffective or arrogant people
More informationDebra Dupree, MA, MFT Advanced Practitioner in Workplace Mediation Certified Conflict Coach THE EMOTIONALLY INTENSE EMPLOYEE
Debra Dupree, MA, MFT Advanced Practitioner in Workplace Mediation Certified Conflict Coach THE EMOTIONALLY INTENSE EMPLOYEE EVERY ORGANIZATION PAYS A But few know how much it is! Dan Dana, Ph.D. Mediation
More informationBorderline Personality Disorder
Borderline Personality Disorder Danielle Fearn Metro North Mental Health Nicola Bristed Consumer and Carer Rep (PiR) Thursday 2 November 2017 Borderline Personality Disorder (BPD) Diagnosis Clinical Definition
More informationPersonality Disorders
Personality Disorders Personality disorder inflexible and maladaptive personality traits cause significant functional impairment or distress Axis II of DSM-IV-TR Difficulties in diagnosis Everyone exhibits
More informationNote: If criteria are met prior to the onset of Schizophrenia, add "Premorbid," e.g., "Paranoid Personality Disorder (Premorbid)."
Page 1/10 Personality Disorders 101 admin, Sunday 06 May 2012-12:47:00 Listed below are some of the recognized personality disorders that frequently contribute to rocky marriages, and ultimately, to divorce.
More informationChapter 2 Lecture. Health: The Basics Tenth Edition. Promoting and Preserving Your Psychological Health
Chapter 2 Lecture Health: The Basics Tenth Edition Promoting and Preserving Your Psychological Health OBJECTIVES Define each of the four components of psychological health, and identify the basic traits
More informationNeurotic and Personality Disorders
Neurotic and Personality Disorders LPT Gondar Mental Health Group www.le.ac.uk Neurosis Originally coined by the Scottish physician William Cullen in 1769. Included a range of conditions e.g. epilepsy,
More informationThe following is a brief summary of the main points of the book.
In their book The Resilience Factor (Broadway Books 2002), Reivich and Shatte describe the characteristics, assumptions and thinking patterns of resilient people and show how you can develop these characteristics
More informationAppendix C Discussion Questions for Student Debriefing: Module 3
Appendix C Discussion Questions for Student Debriefing: Module 3 Frequently Asked Questions (And Responses!) Q: What is the role of biological factors in the development of depression? A: Clinical depression
More informationDialectical Behaviour Therapy (DBT) Information Leaflet
Dialectical Behaviour Therapy (DBT) Information Leaflet 2 What does Dialectical mean? Dialectical means: Arriving at a truth by exchanging different ideas, opinions and points of view. What is Dialectical
More informationWinter Night Shelters and Mental Healh Barney Wells, Enabling Assessment Service London.
Winter Night Shelters and Mental Healh Barney Wells, Enabling Assessment Service London. Introduction goals of session - What is mental health - What is interaction between poor mental health and CWS -
More informationRCHC Case Presentation
Michael Kennedy, MFT Division Director RCHC Case Presentation Starring Melissa Ladrech as Susan and Michael Kozart as Dr. Keigh The following case is presented in three video installments. After each installment,
More informationBorderline Personality Disorder and Addiction. What s in a name? DSM-IV TR Diagnostic Criteria. Erica Hoff, PhD Licensed Clinical Psychologist
Borderline Personality Disorder and Addiction Erica Hoff, PhD Licensed Clinical Psychologist What s in a name? Term first appeared in early 20 th century Borderline between neurotic and psychotic symptoms
More informationPersonality disorders Dr. Sarah DeLeon, MD PGYII, Psychiatry Wayne State University/Detroit Medical Center
Personality disorders Dr. Sarah DeLeon, MD PGYII, Psychiatry Wayne State University/Detroit Medical Center Introduction Personality disorders are enduring patterns of behavior and inner experiences that
More informationCan my personality be a disorder?!
Can my personality be a disorder?! Chapter 11- Personality Disorders What is Personality? How would YOU describe your own personality? There are many characteristics of personality: George is shy Karen
More informationOther Disorders Myers for AP Module 69
1 Other s Myers for AP Module 69 Describe the general characteristics of somatic symptom disorders. How does culture influence people s expression of physical complaints? Compare the symptoms of conversion
More informationSelf-injury, also called self-harm, is the act of deliberately harming your own body, such as cutting or burning yourself. It's typically not meant
Subtitle Self-injury, also called self-harm, is the act of deliberately harming your own body, such as cutting or burning yourself. It's typically not meant as a suicide attempt. Rather, self-injury is
More informationChapter 3 Self-Esteem and Mental Health
Self-Esteem and Mental Health How frequently do you engage in the following behaviors? SCORING: 1 = never 2 = occasionally 3 = most of the time 4 = all of the time 1. I praise myself when I do a good job.
More informationby Odd or Eccentric Behavior Paranoid Personality Disorder Pervasive suspiciousness Excessive mistrust of others No delusional thinking Overly sensiti
Chapter Eleven: Personality Disorders PSY 440: Abnormal Psychology Dr. Rick Grieve Western Kentucky University Personality Disorders Personality Disorder Excessively rigid patterns of behavior or ways
More informationPractical Tips for Dealing with Difficult People (or What Do I Do In The Real World?)
Practical Tips for Dealing with Difficult People (or What Do I Do In The Real World?) Ronald Fraser, MD, CSPQ, FRCPC Associate Professor Department of Psychiatry McGill University Dalhousie University
More informationHow to Win Friends and Influence People Lesson 6 Psychological Patterns and Disorders
How to Win Friends and Influence People Lesson 6 Psychological Patterns and Disorders What are psychological disorders? Mental health workers view psychological disorders as ongoing patterns of thoughts,
More informationAlopecia, Teens and. An Information Sheet for Parents, Guardians and Family Members.
Alopecia, Teens and Mental Health An Information Sheet for Parents, Guardians and Family Members. Research has shown that individuals living with Alopecia Areata may be at a higher risk of developing depression,
More informationK I N G. mentally ill E N. 38 myevt.com exceptional veterinary team March/April 2012
W OR K I N G W IT H mentally ill C LI E N TS 38 myevt.com exceptional veterinary team March/April 2012 Corissa C. Lotta, PhD, and Stacie L. Fishell, MA Peer Reviewed March/April 2012 exceptional veterinary
More informationKey Steps for Brief Intervention Substance Use:
Brief Intervention for Substance Use (STEPS) The Brief Intervention for Use is an integrated approach to mental health and substance abuse treatment. Substance abuse can be co-morbid with depression, anxiety
More informationAttention Deficit and Disruptive Behavior Disorders
Attention Deficit and Disruptive Behavior Disorders Introduction Attention deficit and disruptive behavior disorders are commonly known as child behavior disorders. A child behavior disorder is when a
More informationA-Z of Mental Health Problems
Mental health problems can cover a broad range of disorders, but the common characteristic is that they all affect the affected person s personality, thought processes or social interactions. They can
More informationCopyright 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill
Copyright 2014 All rights reserved. No reproduction or distribution without the prior written consent of CHAPTER PREVIEW Defining/Explaining Abnormal Behavior Anxiety-Related Disorders Mood-Related Disorders
More informationUnderstanding Narcissistic Personality: A Brief Introduction NEA-BPD Call-In January 13, 2109
Understanding Narcissistic Personality: A Brief Introduction NEA-BPD Call-In January 13, 2109 Frank Yeomans, M.D., Ph.D. Personality Disorders Institute Weill Medical College of Cornell University Columbia
More informationAbnormal Psychology. Defining Abnormality
Abnormal Psychology Defining Abnormality Statistical Approach abnormality = infrequency but this is not sufficient on its own Valuative Approach abnormality = social deviance unacceptable or doesn t conform
More informationCharacteristic patterns of behavior, thought, and emotion that exhibit relative consistency across time and situation 1
Personality Disorders in in Primary Care Jennifer S. Cheavens, Ph.D Assistant Professor Department of Psychology The Ohio State University Wexner Medical Center Current Definition of Personality Characteristic
More informationUniversity Staff Counselling Service
University Staff Counselling Service Anxiety and Panic What is anxiety? Anxiety is a normal emotional and physiological response to feeling threatened, ranging from mild uneasiness and worry to severe
More informationPsychological Disorders. Schizophrenia Spectrum & Other Psychotic Disorders. Schizophrenia. Neurodevelopmental Disorders 4/12/2018
Psychological s Schizophrenia Spectrum & Other Psychotic s Schizophrenia Spectrum & Other Psychotic s 0Presence of delusions, hallucinations, disorganized thinking/speech, disorganized or abnormal motor
More informationPhysical complaints without organic basis Occur when a person manifests a psychological problem through a physiological (physical) symptom.
Forms: Somatic Symptom Disorders Physical complaints without organic basis Occur when a person manifests a psychological problem through a physiological (physical) symptom. Conversion Disorder: Report
More informationCan my personality be a disorder?!
Can my personality be a disorder?! Chapter 11- Personality Disorders How would you describe your personality? A personality refers to a distinctive set of behavior patterns that make up our individuality..
More informationCCM Conflict Coaching -- Workplace. Coaching High Conflict Parties -Dealing with Defensiveness -Coaching the HCE Conflict Coaching Matters LLC
CCM Conflict Coaching -- Workplace Coaching High Conflict Parties -Dealing with Defensiveness -Coaching the HCE 1 Conflict Coaching Matters LLC Goals Dealing with Defensiveness Understand High Conflict
More informationPERFECTIONISM Inwardly-Focused Outwardly-Focused
PERFECTIONISM People who are perfectionistic have unrealistically high standards for themselves and/or other people, and therefore end up feeling like they or other people are never good enough. Since
More informationTHE USE OF DIALECTICAL BEHAVIOR THERAPY WITH FORENSIC CLIENTS WITH AUTISM SPECTRUM DISORDER
THE USE OF DIALECTICAL BEHAVIOR THERAPY WITH FORENSIC CLIENTS WITH AUTISM SPECTRUM DISORDER DR JOSEPH ALLAN SAKDALAN AND SABINE VISSER CLINICAL FORENSIC AND NEUROPSYCHOLOGIST (NZ) APRIL 2018 OUTLINE OF
More informationWe admitted that we were powerless over alcohol that our lives had become unmanageable. Alcoholics Anonymous (AA) (2001, p. 59)
Step One 22 istockphoto.com/qingwa We admitted that we were powerless over alcohol that our lives had become unmanageable. Alcoholics Anonymous (AA) (2001, p. 59) Before beginning this exercise, please
More informationBORDERLINE PERSONALITY DISORDER: A LITTLE COMPASSION CAN GO A LONG WAY
BORDERLINE PERSONALITY DISORDER: A LITTLE COMPASSION CAN GO A LONG WAY Jean Clore, PhD, LCP Associate Program Director & Assistant Professor Department of Psychiatry & Behavioral Medicine University of
More informationAssertive Communication/Conflict Resolution In Dealing With Different People. Stephanie Bellin Employer Services Trainer
Assertive Communication/Conflict Resolution In Dealing With Different People Stephanie Bellin Employer Services Trainer The Passive Communicator Often complain and feel they are being treated unfairly.
More informationSection 4 - Dealing with Anxious Thinking
Section 4 - Dealing with Anxious Thinking How do we challenge our unhelpful thoughts? Anxiety may decrease if we closely examine how realistic and true our unhelpful/negative thoughts are. We may find
More informationMental Illness and Disorders Notes
Mental Illness and Disorders Notes Stigma - is a negative and often unfair about mental illness and disorders can cause people with these to not seek help. Deny problem, feel shame and -feel as if they
More informationDisclosures. I have no disclosures
Disclosures I have no disclosures The Obsessive- Compulsive Patient DSM-V Criteria for 301.4 Obsessive-Compulsive Personality Disorder A pervasive pattern of preoccupation with orderliness, perfectionism,
More informationModule 2 Mentalizing
Module 2 Mentalizing It is thought that the human brain is essentially made up of three different brain structures: the brainstem, the limbic system and the cortex. 1. The brainstem: The reptilian or primitive
More informationThe Psychotherapy File
The Psychotherapy File An Aid to Understanding Ourselves Better Published April 2000 V.04.00 Association for Cognitive Analytic Therapy 3rd Floor, South Wing, Division of Academic Psychiatry enquiries@acat.org.uk
More informationMental Health Nursing: Self- Concept Disorders. By Mary B. Knutson, RN, MS, FCP
Mental Health Nursing: Self- Concept Disorders By Mary B. Knutson, RN, MS, FCP A Definition of Self-concept All notions, beliefs, and convictions that constitute an individual s knowledge of self and influence
More informationHow to Approach Someone Having a Mental Health Challenge
How to Approach Someone Having a Mental Health Challenge Susan Allen-Samuel, M.S. NAMI NH Copyright NAMI NH, 2013. Do not use printed or web version of this document for other than personal use without
More informationWe admitted that we were powerless over alcohol that our lives had become unmanageable.
Step One We admitted that we were powerless over alcohol that our lives had become unmanageable. Alcoholics Anonymous (AA) (2001, p. 59) Before beginning this exercise, please read Step One in Twelve Steps
More informationHelping Your Asperger s Adult-Child to Eliminate Thinking Errors
Helping Your Asperger s Adult-Child to Eliminate Thinking Errors Many people with Asperger s (AS) and High-Functioning Autism (HFA) experience thinking errors, largely due to a phenomenon called mind-blindness.
More informationHuman Behavior Mr. Minervini Ch 15: Abnormal Psychology/Psychopathology Diagnosis for Richard Kuklinski a.k.a. The Iceman
Human Behavior Mr. Minervini Ch 15: Abnormal Psychology/Psychopathology Diagnosis for Richard Kuklinski a.k.a. The Iceman 1. Paranoid Personality Disorder What is paranoid personality disorder? Paranoid
More informationFamily Connections Family Education
Page 5 Important considerations Important Considerations The disorder is heterogeneous with many looks or presentations. Medication effects are usually modest at best, and can have negative effects as
More informationCaring for you. Caring for our Communities. Since 1987
Caring for you. Caring for our Communities. Since 1987 Mental Health in the Workplace and How to Support it Kelsi Baine, MSc. CCC. Executive Director, Counsellor Presentation outline: What is mental health
More informationWhose Problem Is It? Mental Health & Illness in Long-term Care
Whose Problem Is It? Mental Health & Illness in Long-term Care Revised by M. Smith (2005) from M. Smith & K.C. Buckwalter (1993), Whose Problem Is It? Mental Health & Illness in Long-term Care, The Geriatric
More informationmedical attention. Source: DE MHA, 10 / 2005
Mental Health EMERGENCIES Mental Health: Emergencies This presentation deals with teen suicide, which is a most difficult topic to consider. It is presented upon recommendations from national public and
More informationNonjudgmentally and Cognitive Therapy
Nonjudgmentally and Cognitive Therapy See, but don t evaluate. Take a nonjudgmental stance. Just the facts. Focus on the what, not the good or bad, the terrible or wonderful, the should or should not.
More informationChapter 1. Dysfunctional Behavioral Cycles
Chapter 1. Dysfunctional Behavioral Cycles For most people, the things they do their behavior are predictable. We can pretty much guess what someone is going to do in a similar situation in the future
More informationAgenda. Challenging Issues in CBT: Handling the Difficult Patient. Readings. Readings. Specifying the Difficulty. Specifying the Difficulty
Agenda Challenging Issues in CBT: Handling the Difficult Patient Judith S. Beck, PhD President, Beck Institute for Cognitive Therapy and Research Bala Cynwyd, Pennsylvania Clinical Associate Professor
More informationLeadership Traits and Ethics
Chapter 2 Leadership Traits and Ethics Chapter 2 Learning Outcomes List the benefits of classifying personality traits. Describe the Big Five personality dimensions. Explain the universality of traits
More informationIndividual Planning: A Treatment Plan Overview for Individuals with Somatization Disorder
COURSES ARTICLE - THERAPYTOOLS.US Individual Planning: A Treatment Plan Overview for Individuals with Somatization Disorder Individual Planning: A Treatment Plan Overview for Individuals with Somatization
More informationPerfectionism and mindset
Perfectionism and mindset Perfectionism Being perfect sounds like a good thing, but perfectionism gets seriously in the way of learning. Rates of perfectionism are higher at Nossal than in other schools.
More informationUnderstanding and Managing Clients Displaying Characterological Behaviors:
Understanding and Managing Clients Displaying Characterological Behaviors: Special Focus on Borderline and Narcissistic Personality Disorders Author: William Malone, MSW, LISW-S 5 CE Hours Copyright 2017
More informationA Prosocial Behavior/Bystander Intervention Program for Students
A Prosocial Behavior/Bystander Intervention Program for Students Developed By: The University of Arizona C.A.T.S. Life Skills Program In Partnership with the NCAA STEP UP! to: Anger and Aggression Before
More informationNeurobiology of Sexual Assault Trauma: Supportive Conversations with Victims
Neurobiology of Sexual Assault Trauma: Supportive Conversations with Victims Jim Hopper, Ph.D. November 2017 Handout 1: Using Neurobiology of Trauma Concepts to Validate, Reassure, and Support Note: In
More informationStep One for Gamblers
Step One for Gamblers We admitted we were powerless over gambling that our lives had become unmanageable. Gamblers Anonymous (GA) (1989b, p. 38) Before beginning this exercise, please read Step One in
More informationThe Bad News and the Good News: Sexual Abuse, Sexual Education, and Positive Sexuality
The Bad News and the Good News: Sexual Abuse, Sexual Education, and Positive Sexuality Christine White Legal Advocate for People with Developmental Disabilities April 7, 2011 No part of this slideshow
More information2018 Texas Focus: On the Move! Let s Talk: Starting the Mental Health Conversation with Your Teen Saturday, March 3, :45-11:15 AM
Texas School for the Blind & Visually Impaired Outreach Programs www.tsbvi.edu 512-454-8631 1100 W. 45 th St. Austin, TX 78756 2018 Texas Focus: On the Move! Let s Talk: Starting the Mental Health Conversation
More informationAverage? Anyone at the extremes is? Violating social norms? Cultural Norms? Experiencing subjective discomfort? Maladaptive Behavior?
Psychopathology: scientific study of abnormal behavior Historically, things haven t always gone well Trepanning in ancient times (frees demons) Hippocrates: humors out of balance Middle Ages: demonic possession
More informationNormal Personality Development and Personality Disorders
Normal Personality Development and Personality s Learning Objectives Be able to describe the various personality disorders Be able to apply the personality disorder categories to patient scenarios Janet
More informationIntroduction into Psychiatric Disorders. Dr Jon Spear- Psychiatrist
Introduction into Psychiatric Disorders Dr Jon Spear- Psychiatrist Content Stress Major depressive disorder Adjustment disorder Generalised anxiety disorder Post traumatic stress disorder Borderline personality
More informationUnderstanding & Managing
Understanding & Managing High Conflict People Bill Eddy, LCSW, Esq. People for People October 6, 2015 The Continuum Effective Problem Solving Situational Difficulties High Conflict People Normal Range
More informationCHILDREN WITH SEXUALLY AGGRESSIVE BEHAVIORS. November 9, 2016
CHILDREN WITH SEXUALLY AGGRESSIVE BEHAVIORS November 9, 2016 Children who are sexually aggressive and have sexual behavior problems need special attention, care, and supervision. These are complex situations
More informationCourage is resistance to fear, mastery of fear not absence of fear. ~Mark Twain
Courage is resistance to fear, mastery of fear not absence of fear. ~Mark Twain Now that we ve learned about many of the skills you ll see in CBT, let s talk about how to put them all together. This section
More informationQuick Start Guide for Video Chapter 2: What Is Addiction?
Quick Start Guide for Video Chapter 2: What Is Addiction? Materials and Preparation Needed * Prepare to show the video on a TV or monitor. * Print the chapter 2 fact sheet, Addiction, for each client.
More informationMoving fear into USEFUL anxiety. PACER 12 August 2017 Anne R. Gearity, PhD
Moving fear into USEFUL anxiety PACER 12 August 2017 Anne R. Gearity, PhD Today Examine the connection between fear debilitating anxiety and anxiety that can be useful. Examine ways to restore useful anxiety
More information