Abstract

Personality disordered patients present with multiple problem areas and potential targets of change. This complex clinical situation can be addressed by an integrated approach to the treatment by using treatment strategies and techniques from the various schools of therapy, sequenced and adapted to the individual patient. An optimal choice and sequencing of treatment techniques is organized around general treatment strategies (assessment and case formulation, treatment structuring, observing the therapeutic relationship, addressing problematic personality organization, and addressing sequential goals) with the severity of the personality disturbance in mind. The biggest threat to successful integration of the treatment is the reaction of severe personality disordered patients who lack an integrated sense of self and suffer from intense, fluctuating emotions that challenge an inexperienced, reactive therapist.

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