Avoidant Personality Disorder

Integrated Wilderness Therapy

Treatment Summary:

An interesting treatment for Avoidant Personality Disorder is: Integrated Wilderness Therapy (IWT). This is a form of group therapy that takes the group into the great outdoors. As has been stated earlier there is little real in-depth research into the effectiveness of APD treatments and therefore it is important to try different approaches that might work in overcoming this personality disorder or at least diminishing the incapacitating symptoms. In this study two groups were formed with one being an inpatient comparison condition (CC) used individual and group sessions in a hospital setting and the other was the IWT that used a similar approach except took place in a wilderness setting. The goal was to make both the CC and IWT similar in treatment to have “a psychodynamic approach with an interpersonal focus” (Eikenæs et al. 2006, p. 276). There were group sessions, individual sessions (though in the IWT these were not formalized), and art therapy. Then things diverged from there with occupational therapy and physical therapy taking place for the CC group and of course the IWT had a six day trip into an outdoor place that was fairly wild and isolated. The IWT group also took a three day canoe trip near the end of their time away. During the period they were outdoor the members of the group were given different tests and experiences to be accomplished. Integrated Wilderness Therapy proved to be about as affective as the comparison condition for the in-patient hospital group. Both of the groups showed that symptoms were helped and that group members improved in the social aspects and relationship problems that had been prevalent before the treatment took place. The IWT group did have slightly better improvement than the CC group. The clinical trial did show that the IWT worked better with males in the group than with females. It also showed that the males in the CC group tended to slip backwards when followed up with and the males in the IWT actually got better in their follow up time.

• Reference: Eikenaes, I., Gude, T., & Hoffart, A. (2006). Integrated wilderness therapy for avoidant personality disorder. Nordic Journal Of Psychiatry, 60(4), 275-281. doi:10.1080/08039480600790093
• Submitter: Ben Ray

Mentalization-Based Group Therapy for Adolescents

Summary of Treatment: Mentalization-Based Group Therapy (MBT-AA) is primarily based on the original mentalization-based treatment (MBT) used to treat Borderline Personality Disorder but applied to a group setting.  MBT is used to strengthen and reinforce the ability to mentalize for longer periods of time which helps clients with Avoidant Personality Disorder (AvPD) experience less problematic social functioning leading to a happier and more successful life.  MBT-AA consists of two individual case-formulation sessions, three psychoeducational group sessions, 30 MBT based group sessions, and seven sessions specifically for parents.  Clients are asked to use mentalization to reflect on emotions and experiences related to given prompts.  Clients are given opportunities to view minor conflicts experienced by other people, then reflect and discuss as a group.  Clients also participate in pair activities where they reflected on experiences from the previous week.  The MBT-AA approach has shown significant symptom improvement for adolescents with AvPD. 

• Reference: Bo, S., Bateman, A., & Kongerslev, M. T. (2019). Mentalization-based group therapy for adolescents with avoidant personality disorder: Adaptations and findings from a practice-based pilot evaluation. Journal of Infant, Child & Adolescent Psychotherapy, 18(3), 249-262. http://doi-org.tamuct.idm.oclc.org/10.1080/15289168.2019.1625655
• Submitted by: Sean Moore