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Dependent Personality Disorder

Treatments

Psychodynamic Therapy

Treatment Summary: Psychodynamic Therapy involves a close examination into certain past relationships in which their dependent behavior was encouraged. These behaviors are discussed to determine how they are shown in their self-concepts and when dealing with others around them. Cognitive therapists use questioning to expose and resolve certain incorrect beliefs regarding relationships. The therapist would emphasize to the client that the opposite of submission in relationships is not control over others, but instead independence and confidence. When working with clients who have dependent personality disorder, the therapist should be careful to ensure they are not playing into the dependency of the client. The therapist should promote independence.

  • Reference: Harvard Mental Health Letter. (2007). Dependent Personality Disorder. Harvard Mental Health Letter, 23(10), 1-4.
  • Submitter: Katie Cantu

Psychotherapy

Treatment Summary: The most effective approach is one that focuses on the life problems that the patient is having. Some of the goals for individuals with Dependant Personality Disorder are: Building self-confidence is important so that the patient is able to meet their own needs and able to endure the feeling of being alone, Implement assertiveness training, Convey insight into need to try and meet other people's expectations, Verbally clarify boundaries with others, Reduce dependence on relationships while starting to met his or her own needs. Care must be taken in the therapeutic relationship so that the client does not become dependent on counselor.

  • Reference: Demetri, J (2006, Jan. 1). Etiology and treatment of Cluster C personality disorders. Journal of Mental Health Counseling. issn: 1040-2861.
  • Submitter: Becky Ramirez

Cognitive-Existential Therapy

Treatment Summary: The client with dependent personality disorder (DPD) often exhibits an ingrained and pervasive pattern of excessively decision-avoidant behavior related to a need to be taken care of. Cognitive-existential therapy (CET) incorporates psychoeducation with cognitive and existential theories and approaches in order to first teach the client mindfulness, then reframe care-seeking behavior in a conceptual framework centered around mindful decision-making. CET is conceptualized as a four-step process: engagement, pattern search, change, and termination. At the outset of CET, the counselor explores the client's presenting problems through whichever lens, cognitive or existential, best explains the client's personality organization. During the pattern search phase, counselor and client work together to identify which behaviors persist or are inconsistent among the domains of the client's life. Although the counselor will bring these behaviors to the client's awareness, the counselor must be careful to avoid blaming or shaming the client. In the change phase, the counselor brings the client's attention to existential resistance, or the client's pattern of dependency-related behaviors that protect the client from his or her own agency and, by extension, his or her own responsibility for potential negative outcomes. Changes will then be initiated using a series of homework assignments, skills training, and experiential learning tasks. Finally, the termination phase contains the process of solidifying the gains that the client has made in the therapeutic setting.

  • Reference: Bornstein, R. F. (2004). Integrating cognitive and existential treatment strategies in psychotherapy with dependent patients. Journal of Contemporary Psychotherapy, 34 (4), 293-309. doi: 10.1007/s10879-004-2525-7
  • Submitter: Daniela L. Galvez Nelson

Psychodynamic therapy along with cognative behavior therapy

Treatment Summary: Psychodynamic therapy would involve helping the client to examine past relationships; why they were unhealthy and resulted in the feelings that the client felt. Cognative therapy would involve guiding the patient, not instructing or mentoring, through the process of self-examination of the client's feelings about self. The client needs to discover why they feel they are not able to be self-relient or self-sufficient. Homework is a helpful tool along with role playing.

  • Reference: Harvard Mental Health Letter; Apr2007, Vol. 23 Issue 10, p1-4, 4p
  • Submitter: Leasa Arms

Integrated Cognitive and Existential Therapy

Treatment Summary: Cognitive and Existential therapy techniques are combined and used to help the patient. Both therapies focus on the role of self-distortions and practicing new ways to responding to outside therapy. The multifaceted nature of dependency suggests that integrated treatment strategies may hold more promise than traditional approaches.

  • Reference: Bornstein, R. (2004) Integrating cognitive and existential treatment strategies in psychotherapy with dependent patients. Journal of Contemporary Psychotherapy, 34 (4), 293-309.
  • Submitter: N/A

Integrated Cognitive and Existential therapies

Treatment Summary: One of the primary focuses of treatment for DPD is to change the patient's self-concept to one that seeks greater independence and accepts responsibility for their own choices. Cognitive-behavioral therapy (CBT) approaches this task through cognitive restructuring. Patients are encouraged to explore how and when their maladaptive, dependent schema formed, what currently helps maintain the schema, what strategies they use to avoid related anxiety, and what coping mechanisms relieve unavoidable anxiety. Existential therapy sees the primary issue of DPD as a belief that the patient is no longer in control of their own life. Being unable to cope with their own mortality leaves them feeling powerless, and causes them to externalize personal responsibility onto others. For this reason, treatment should remain focused on the "here and now" rather than future. Therapy should focus on helping patients recognize new opportunities and choices in their lives, and encourage ways to explore their true self. CBT and Existential methods share several common traits that lend to an integrative approach. While CBT strategies open patients to new ways of thinking, Existentialism supports this by working to decrease the patient's defense mechanisms and confront their distorted beliefs about themselves. They both seek to promote change by encouraging more open and real experiences of self and others. In addition, experiential practice and learning outside of therapy can be easily incorporated through activities such as social-skills training, problem-solving, journal writing, skill building tasks, role play scenarios, and safe risk-taking both in and out of therapy sessions.

  • Reference: Bornstein, R.F. (2004). Integrating cognitive and existential treatment strategies in psychotherapy with dependent patients. Journal of Contemporary Psychotherpa, 34 (4), 293-309.
  • Submitter: Sarah Duke