Histrionic Personality Disorder 

Treatments

Interpersonal Therapy and Functional Analytic Psychotherapy    

Treatment Summary: The treatments typically provided to clients meeting criteria for HPD are psychodynamic, are longer-term treatments and focus on interpersonal process. The interpersonal psychotherapy approach used here, Functional Analytic Psychotherapy (FAP) allows the therapist and supervisor to gather data to demonstrate the effectiveness of this treatment for this type of client consistent with other behavioral and cognitive behavioral approaches. FAP is based upon a simple theory, that all people act the way we do because of the contingencies of reinforcement we have experienced in past relationships. Based on that, it follows that clinical improvements, healing, or psychotherapeutic change, all of which are certain acts of the client, also involve contingencies of reinforcement that occur in the relationship between the client and therapist. Important therapeutic implications, to be discussed below, follow from the combination of this theory of change and behavioral definitions of “act” and “contingency.” We complete this section on theory with discussions of context, rule governance, and functional similarity, all of which provide guidance for FAP as an integrative approach. 

Reference: Callaghan, G., Summers, C. & Weidman, M. (2003). The Treatment of Histrionic and Narcissistic Personality Disorder Behaviors: A Single-Subject Demonstration of Clinical Improvement Using Functional Analytic Psychotherapy. Journal of Contemporary Psychotherapy, 33 (4),321 – 339. 

Submitter: Barry Crum 

Cognitive Analytic Therapy 

Treatment Summary: Treatment for Histrionic disorder involves the use of cognitive-analytic therapy (CAT) that is a structured time-limited focal psychotherapy. Once the patient has been assessed the patient’s history is drawn up in a sequential diagrammatic reformation (SDR) that describes their current “triggers” and what may have caused this. From the SDR, the therapist can outline the target problems. CAT involves the active use of the SDR in constructing therapeutic ‘exits’ from the roles and procedures identified on the SDR. In the beginning, the therapist uses a letter created by the therapist that is read to the patient to reformulate the origins of their distress and stating target problems and procedures. Throughout the therapy sessions, the patient works on the different “triggers” and techniques that will help the patient. The last session set up between the patient and the therapist, both will prepare and read a ‘goodbye letter’. The function of the letter from the therapist is to summarize achievements made in the therapy, to signal challenges that appear to lie ahead for the patient and acknowledge the abandonment issues that can be brought up at termination of therapy. 

Reference: Kellett, S. (2007). A time series evaluation of the treatment of histrionic personality disorder with cognitive analytic therapy. Psychology and Psychotherapy: Theory, Research and Practice, 80, 389-405. 

Submitter: Melva Terpstra