NRNP 6635 Assignment: Therapy for Clients With Personality Disorders

NRNP 6645 Week 10 Assignment – Borderline Personality Disorder

NRNP 6645 Week 10 Assignment – Borderline Personality Disorder

Personality disorders refer to ways in which personality persistently causes problems for an individual or those around them. They are characterized by chronic patterns of inner experience and inflexible behaviors (Kulacaoglu & Kose, 2018). This paper seeks to describe Borderline personality disorder (BPD), including its DSM-5 diagnostic criteria, therapeutic approach to treat BPD, and discuss the therapeutic relationship in psychiatry.

Borderline Personality Disorder

BPD presents with a marked instability in functioning, mood, affect, interpersonal relationships, and, at times, reality testing. Persons with BPD exhibit intense emotional sensitivity and an inability to regulate intense emotional responses (Kulacaoglu & Kose, 2018). The DSM-5 diagnostic criterion is based on a persistent pattern of instability of interpersonal relationships, self-image, affect, and significant impulsivity. BPD is diagnosed if at least five of the following features are present: Desperate efforts to avoid real or imagined abandonment; A pattern of unstable and intense interpersonal relationships that alternate between extremes of idealization and devaluation; Markedly and persistently unstable self-image or sense of self (Cattane et al., 2017). In addition, there is: Impulsivity in at least two areas that are potentially self-damaging; Recurrent suicidal behavior or self-mutilating behavior; Affective instability due to a marked reactivity of mood; Chronic feelings of emptiness; Intense anger or difficulty controlling anger; Severe dissociative symptoms or transient, stress-related paranoid ideation.

Therapeutic Approach and Modality to Treat BPD

Dialectic behavior therapy (DBT) would be my preferred therapeutic approach to treat a patient with BPD.  BPD is a modification of the standard cognitive-behavioral techniques designed to treat BPD (McMain et al., 2018). I selected DBT because it is currently the only evidence-supported treatment for BPD. Besides, DBT has been established to be useful and effective in the face of the challenges of patient regression, overwhelming affect, and impulsive behavior.DBT focuses on teaching BPD patients four primary skills: Mindfulness, Interpersonal effectiveness, Emotional regulation, and distress tolerance without impulsivity (McMain et al., 2018). DBT effectively alleviates suicidal and self-injurious behaviors, hospitalizations, treatment dropout, and self-reports of anger and anxious ruminations.

Therapeutic Relationship in Psychiatry

A therapeutic relationship is an interaction between two individuals, usually a caregiver and a care receiver. The input from both parties promotes a climate of healing, growth promotion, and disease prevention (Bolsinger et al., 2020). A therapeutic relationship is goal-oriented. The nurse and client decide the goal of the relationship. When informing a patient of their BPD diagnosis, I would create a rapport to avoid damaging the therapeutic relationship. I would demonstrate geniuses by being aware of what the client is experiencing internally and expressing the awareness in the therapeutic relationship (Bolsinger et al., 2020). I would also be empathetic to the client by remaining emotionally separate from the client. In an individual session, I would share the BPD diagnosis by explaining to the client of the assessment findings, the diagnosis, treatment options, and complications (Bolsinger et al., 2020).  In a family session, I would inform the members of the identified problems, diagnosis, treatment options, and how the family can help the patient in their condition. In a group setting, I would wait until the end of the session and inform the client of the diagnosis to promote confidentiality.

Conclusion

BPD is characterized by a pervasive pattern of impulsiveness, emotional deregulation, an unstable sense of identity, and complicated interpersonal relationships. DBT is used in BPD to teach patients mindfulness, assertiveness, emotional regulation, and distress tolerance without impulsivity. The goal of a therapeutic relationship is learning and growth promotion to bring some form of change in the client’s life.

 

 

References

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. https://doi.org/10.3389/fpsyt.2019.00965

Cattane, N., Rossi, R., Lanfredi, M., & Cattaneo, A. (2017). Borderline personality disorder and childhood trauma: exploring the affected biological systems and mechanisms. BMC psychiatry17(1), 1-14. https://doi.org/10.1186/s12888-017-1383-2

Kulacaoglu, F., & Kose, S. (2018). Borderline Personality Disorder (BPD): in the midst of vulnerability, Chaos, and Awe. Brain sciences8(11), 201. https://doi.org/10.3390/brainsci8110201

McMain, S. F., Chapman, A. L., Kuo, J. R., Guimond, T., Streiner, D. L., Dixon-Gordon, K. L., … & Hoch, J. S. (2018). The effectiveness of 6 versus 12-months of dialectical behavior therapy for borderline personality disorder: the feasibility of shorter treatment and evaluating responses (FASTER) trial protocol. BMC psychiatry18(1), 1-16. https://doi.org/10.1186/s12888-018-1802-z

Assignment: Therapy for Clients With Personality Disorders

Individuals with personality disorders often find it difficult to overcome the enduring patterns of thought and behavior that they have thus far experienced and functioned with in daily life. Even when patients are aware that personality-related issues are causing significant distress and functional impairment and are open to counseling, treatment can be challenging for both the patient and the therapist. For this Assignment, you examine specific personality disorders and consider therapeutic approaches you might use with clients.

NRNP 6645 Week 10 Assignment – Borderline Personality Disorder

NRNP 6645 Week 10 Assignment – Borderline Personality Disorder

To prepare:

  • Review this week’s Learning Resources and reflect on the insights they provide about treating clients with personality disorders.
  • Select one of the personality disorders from the DSM-5 (e.g., paranoid, antisocial, narcissistic). Then, select a therapy modality (individual, family, or group) that you might use to treat a client with the disorder you selected.

The Assignment:

Succinctly, in 1–2 pages, address the following:

  • Briefly describe the personality disorder you selected, including the DSM-5 diagnostic criteria.
  • Explain a therapeutic approach and a modality you might use to treat a client presenting with this disorder. Explain why you selected the approach and modality, justifying their appropriateness.
  • Next, briefly explain what a therapeutic relationship is in psychiatry. Explain how you would share your diagnosis of this disorder with the client in order to avoid damaging the therapeutic relationship. Compare the differences in how you would share your diagnosis with an individual, a family, and in a group session.

Support your response with specific examples from this week’s Learning Resources and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

By Day 7

Submit your Assignment. Also attach and submit PDFs of the sources you used.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK10Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 10 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 10 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 10 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 10 Assignment draft and review the originality report.

Submit Your Assignment by Day 7

To Participate in this Assignment:

Week 10 Assignment

Name: NRNP_6645_Week10_Assignment_Rubric

Excellent

90%–100%

Good

80%–89%

Fair

70%–79%

Poor

0%–69%

Succinctly, in 1–2 pages, address the following: • Briefly describe the personality disorder you selected, including the DSM-5 diagnostic criteria.
Points Range: 14 (14%) – 15 (15%)
The response includes an accurate and concise description of the personality disorder, including the DSM-5 diagnostic criteria.
Points Range: 12 (12%) – 13 (13%)
The response includes an accurate description of the personality disorder, including the DSM-5 diagnostic criteria.
Points Range: 11 (11%) – 11 (11%)
The response includes a somewhat vague or inaccurate description of the personality disorder, including the DSM-5 diagnostic criteria.
Points Range: 0 (0%) – 10 (10%)
The response includes a vague or inaccurate description of the personality disorder, including the DSM-5 diagnostic criteria.
• Explain a therapeutic approach and a modality you might use to treat a client presenting with this disorder. Explain why you selected the approach and modality, justifying their appropriateness.
Points Range: 23 (23%) – 25 (25%)

The response includes an accurate and concise explanation of both a therapeutic approach and a modality that could be used to treat a client presenting with this disorder.

The response includes a concise explanation of why the approach and modality were selected, with strong justification for why they are appropriate for the disorder.

Points Range: 20 (20%) – 22 (22%)

The response includes an accurate explanation of both a therapeutic approach and a modality that could be used to treat a client presenting with this disorder.

The response includes an explanation of why the approach and modality were selected, with adequate justification for why they are appropriate for the disorder.

Points Range: 18 (18%) – 19 (19%)

The response includes a somewhat vague or inaccurate explanation of both a therapeutic approach and a modality that could be used to treat a client presenting with this disorder.

The response includes a vague or inaccurate explanation of why the approach and modality were selected, with a somewhat vague or inaccurate justification for why they are appropriate for the disorder.

Points Range: 0 (0%) – 17 (17%)

The response includes a vague or inaccurate explanation of a therapeutic approach and a modality that could be used to treat a client presenting with this disorder. Or, response is missing.

The response includes a vague or inaccurate explanation of why the approach and modality were selected, with poor justification for why they are appropriate for the disorder. Or, response is missing.

• Briefly explain what a therapeutic relationship is in psychiatry. Explain how you would share your diagnosis of this disorder with the client in order to avoid damaging the therapeutic relationship. Compare the differences in how you would share your diagnosis with an individual, a family, and in a group session.
Points Range: 27 (27%) – 30 (30%)

The response includes an accurate and concise explanation of the therapeutic relationship in psychiatry.

The response clearly and concisely explains an approach for sharing the disorder diagnosis to avoid damaging the therapeutic relationship, and how this approach would be similar or different in individual, family, and group sessions.

Points Range: 24 (24%) – 26 (26%)

The response includes an accurate explanation of the therapeutic relationship in psychiatry.

The response adequately explains an approach for sharing the disorder diagnosis to avoid damaging the therapeutic relationship, and how this approach would be similar or different in individual, family, and group sessions.

Points Range: 21 (21%) – 23 (23%)

The response includes a somewhat vague or incomplete explanation of the therapeutic relationship in psychiatry.

The response provides a somewhat vague or incomplete explanation of an approach for sharing the disorder diagnosis to avoid damaging the therapeutic relationship, and how this approach would be similar or different in individual, family, and group sessions.

Points Range: 0 (0%) – 20 (20%)

The response includes a vague and inaccurate explanation of the therapeutic relationship in psychiatry. Or, response is missing.

The response provides a vague or incomplete explanation of an approach for sharing the disorder diagnosis to avoid damaging the therapeutic relationship, and how this approach would be similar or different in individual, family, and group sessions. Or, response is missing.

·   Support your approach with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. PDFs are attached.
Points Range: 14 (14%) – 15 (15%)
The response is supported by specific examples from this week’s media and at least three peer-reviewed, evidence-based sources from the literature that provide strong support for the rationale provided. PDFs are attached.
Points Range: 12 (12%) – 13 (13%)
The response is supported by examples from this week’s media and three peer-reviewed, evidence-based sources from the literature that provide appropriate support for the rationale provided. PDFs are attached.
Points Range: 11 (11%) – 11 (11%)
The response is supported by examples from this week’s media and two or three peer-reviewed, evidence-based sources from the literature. Examples and resources selected may provide only weak support for the rationale provided. PDFs may not be attached.
Points Range: 0 (0%) – 10 (10%)
The response is supported by vague or inaccurate examples from the week’s media and/or evidence from the literature, or is missing.
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
Points Range: 5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineates all required criteria.

Points Range: 4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

Points Range: 3.5 (3.5%) – 3.5 (3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment are vague or off topic.

Points Range: 0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion were provided.

Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Points Range: 4 (4%) – 4 (4%)
Contains 1 or 2 grammar, spelling, and punctuation errors.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains 3 or 4 grammar, spelling, and punctuation errors.
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors.
Points Range: 4 (4%) – 4 (4%)
Contains 1 or 2 APA format errors.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains 3 or 4 APA format errors.
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors.
Total Points: 100
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