NRNP 6645 Assignment: Therapy for Clients With Personality Disorders

NRNP 6645 Assignment: Therapy for Clients With Personality Disorders

Personality disorders (PDs) are expressions of extreme personality traits that impede an individual’s daily living resulting in functional limitations and significant suffering. PDs are prevalent and are commonly encountered in almost all forms of health care. They are connected with poor health outcomes, low quality of life, and premature mortality (Ekselius, 2018). The purpose of this paper is to describe a personality disorder, including an ideal therapeutic approach or treatment modality for the disorder, and discuss the therapeutic relationship in psychiatry.

Description of the Personality Disorder

Histrionic personality disorder (HPD) is under cluster B (dramatic and emotional) of personality disorders. Individuals with HPD appear interesting, amiable, and intimate, but some people believe they are shallow and insincere and are petty, self-centered, and demanding in their relationships (Ekselius, 2018). HPD begins in the early years of life and appears in various backgrounds. The  DSM-V diagnostic criteria include at least five of the following features: Uncomfortable in situations they are not the center of attention; Inappropriate sexually seductive behavior; Rapid shifts of emotions; Using physical appearance to draw attention; Suggestive; Exaggerated expression of emotions; Impressionistic and vague speech; Considering relationships to be more intimate than they are (Bates et al., 2021).

Therapeutic Approach and Treatment Modality

Schema therapy is the selected therapeutic that I would use to manage a client with HPD. It offers a new approach of psychotherapy entirely designed for chronic personality disorders and severe personality disorde

NRNP 6645 Assignment Therapy for Clients With Personality Disorders

NRNP 6645 Assignment Therapy for Clients With Personality Disorders

rs. Schema therapy was proposed by Jeffrey Young, who stressed the role of early maladaptive schemas in developing and maintaining personality disorders (Gol et al., 2019). The theory of schema-therapy proposes that the primary cause of personality disorders is the existence of early maladaptive schema and confrontational styles. Schema therapy is considered a process that focuses on identifying, adjusting, and changing the schemas. Gol et al. (2019) established that schema-therapies effectively improve symptoms, maladaptive schemas, confirm-seeking, and self-concept of patients with HPD.

Therapeutic Relationship Is In Psychiatry

The therapeutic relationship (TR) is considered the cornerstone of mental health practice, and its importance in psychiatry is greatly emphasized. Bolsinger et al. (2020) explain that a TR has three major aspects: an affective connection between client and therapist, a collaborative nature, and common ability to agree on goals. A positive TR is connected with better therapy outcomes with reference to clinical improvement, re-hospitalization rate, and patient satisfaction.

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Establishing an appropriate TR with a patient with HPD may be challenging due to suggestibility and attention-seeking behavior. When sharing the HPD diagnosis with a client, I would first set boundaries and avoid becoming

NRNP 6645 Assignment Therapy for Clients With Personality Disorders

NRNP 6645 Assignment Therapy for Clients With Personality Disorders

over-involved, over-supportive, self-disclosure, and disclosing feelings about the patient (Bates et al., 2021). This would avoid counter-transference, which damages the therapeutic relationship. In the individual setting, I would share the HPD diagnosis by explaining its meaning and management to the client. In a family setting, I would explain to the family the diagnosis in the presence of the client and discuss how the family can help manage the disease. In a group session, I would put patients with HPD in one group and inform them of their diagnosis and how group therapy offers an opportunity to improve their symptoms and other social skills.


HPD is a psychiatric disorder characterized by a pattern of exaggerated emotions and attention-seeking behaviors. I would use schema therapy, which is founded on the belief that symptoms of HPD alleviate if the schemas are improved. Therapists should avoid counter-transference when handling HPD patients as it affects the therapeutic relationship.


Bates, C., Samghabadi, P., & Richman, S. (2021). Histrionic Personality Disorder.

Bolsinger, J., Jaeger, M., Hoff, P., & Theodoridou, A. (2020). Challenges and opportunities in building and maintaining a good therapeutic relationship in acute psychiatric settings: A narrative review. Frontiers in psychiatry10, 965.

Ekselius, L. (2018). Personality disorder: a disease in disguise. Upsala journal of medical sciences123(4), 194–204.

Gol, A., Sharbaf, H. A., Sedaghat, F., & Rasooli, H. (2019). The effectiveness of schema therapy on the symptoms, severity of early maladaptive schemas, confirm-seeking, and self-concept in histrionic personality disorder.