Restructuring Personality Disorders: A Short-Term Dynamic Approach

by Jeffrey J. Magnavita PhD

Overview

Therapists working with personality-disordered clients must contend with both the complex and often treatment-refractory nature of the Axis II disorders themselves and the growing reluctance of third-party payers to assume the costs of extended treatment. Presenting a flexible, short-term dynamic model, this book shows how to conduct successful therapies with this population. The author synthesizes the work of pioneers in the field of short-term therapy and adds components from a range of other approaches, emphasizing active defense analysis and empathic affirmation of the client's core self. With step-by-step guidelines and extensive case material, the volume demonstrates how to bring about rapid and enduring changes in personality-disordered clients.

Product Details

ISBN-13:	9781572301856
Publisher:	Guilford Publications, Inc.
Publication date:	02/28/1997
Series:	Assessment of Personality and Psychopath Series
Pages:	345
Product dimensions:	6.20(w) x 9.10(h) x 1.40(d)

About the Author

Jeffrey J. Magnavita, Ph.D., ABPP, is the founder of the Connecticut Center for Short-Term Dynamic Psychotherapy and has been in active clinical practice for fifteen years. He trains mental health professionals and lectures on the theory, technique, and science of psychotherapy. Dr. Magnavita was the 1995 recipient of the Distinguished Contribution to the Science of Psychology award given by the Connecticut Psychological Association, for his contributions to the field of psychotherapy. He is a member of the American Psychological Association, Society for Psychotherapy Researchers, Society for Psychotherapy Integration, and the International Society on the Study of Personality Disorders, and is a book reviewer for the journal, Psychotherapy.

Table of Contents

Preface
I. Framework
1. Quantum Change for Personality Disordered Patients
2. The STRP Model: Process, Theory, and Constructs
3. Assessment and Treatment Planning
4. How to Formulate Core Issues
5. Techniques of STRP: The Use of Anxiety and Maximizing the Therapeutic Alliance
6. Comprehensive Restructuring of the Personality
7. Overview of the Treatment Process
II. Process and Technique in the Treatment of the Personality Disorders
8. Cluster C Disorders: The Treatment-Responsive Group
9. Cluster B Disorders: The Mixed-Results Group
10. Cluster A Disorders: The Treatment-Refractory Group
11. Treatment Pitfalls
12. Termination and Follow-Up: Measuring Therapeutic Effectiveness
13. Future Challenges

Interviews

Serves as a text for courses in the treatment of personality disorders and in short-term dynamic psychotherapy. Psychotherapists, regardless of orientation, who treat clients with personality disorders, as well as researchers and students of mental health.

Editorial Reviews

"This is a timely and much needed book. The author presents a systematic approach for understanding and treating personality disorders utilizing short-term dynamic psychotherapy. Clinical examples abound and technical strategies are clearly articulated. This book will be useful for every clinician, teacher, and student of brief dynamic psychotherapy." —Arnold Winston, MD, Chairman Dept. of Psychiatry, Beth Israel Medical Center; Professor and Vice Chairman, Albert Einstein College of Medicine

"Richly grounded in clinical research and up-to-date in theory, this book offers unique blueprints for the complex clinical challenges presented by personality disordered patients. The book is richly studded with clinical wisdom, which will empower the reader to resolve therapeutic roadblocks. Dr. Magnavita's work provides solid, science-based foundations for therapeutic ambition, and hope to a field in desperate need of such a breakthrough." —Manuel Trujillo, M.D., New York University Medical
Center and Bellevue Hospital Center

"Although intended as a brief treatment manual for the personality disorders, Magnavita's text is one of the most intelligent and thoughtful books available on psychotherapy for these difficult to treat disorders. This highly readable book provides a systematic model with associated techniques to deal with each of the major clusters of Axis II in the DSM-IV. It is a volume that is both theoretically coherent and eminently usable by clinicians of all persuasions. Guided by a deep appreciation of the psychodynamics that undergird personality pathology, Dr. Magnavita has written an incisive and engaging synthesis of what should be known to treat these patients effectively." —Theodore Millon, Ph.D., DSc., Dean and Scientific Director, Institute for Advanced Studies in Personology and Psychopathology.

From the Publisher

This book explicates the author's model of short-term restructuring psychotherapy (STRP). This psychodynamic approach is based on Freud's tripartite model and more recent influences, including object relations, self-psychological, and cognitive perspectives. This work also builds upon earlier short-term dynamic approaches, such as those of Sifheos, Malan, and Davanloo. The author offers specific treatment recommendations for work with personality disorders of clusters A, B, and C. Case illustrations are included to facilitate the reader's understanding of STRP in clinical use. The author seeks to integrate psychodynamic perspectives with current concerns regarding utility and efficacy of psychotherapeutic intervention, and demands for brief and short-term work. The book offers a model for personality disordered and other difficult-to-treat cases and contributes to field-wide efforts to bridge a gap between longer term psychodynamic approaches and demands for efficient and time-limited intervention. The book makes a significant contribution to current thinking in short-term dynamic work. The intended audience consists of clinicians already familiar with psychodynamic psychotherapy, psychoanalysis, and short-term dynamic approaches. Mental health professionals who work with personality disordered cases and advanced trainees in related disciplines are also likely to find this work useful. This book is well organized and the material is presented in a clear and concise manner. Citations and references are current and up-to-date. Detailed case vignettes are presented to illustrate treatment technique. Whether STRP gains more widespread notice is an open question, but the author'sefforts to integrate current dynamic thinking regarding personality disorders in light of profession-wide pressures for brief intervention is important. The author also addresses questions of psychotherapy outcome, a significant area given current concerns over accountability. The STRP model adds to the dialogue regarding dynamic thought and applicability in a short-term climate.

Pierre R. Nunez

Presents a flexible, short-term dynamic model for treating personality disorders, synthesizing the work of pioneers in short-term therapy and adding components from other approaches to emphasize active defense analysis and empathic affirmation of the client's core self. Includes step-by-step guidelines and extensive case material. Annotation c. by Book News, Inc., Portland, Or.

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