NRNP 6645 Week 10 Assignment: Therapy for Clients with Personality Disorders-Nursing Essay Examples

Personality involves a way of reasoning, feeling, and behaving that distinguishes an individual from another. The environment, life experiences, and inherited attributes influence personality, which remain perceived as constant over time. A personality disorder refers to an impaired way of thinking, feeling, and behaving, which deviates from the expectations of the person and the culture, leading to functionality issues and distress, and can be long-lasting without treatment. This paper discusses paranoid personality disorder (Therapy for Clients).

Therapy for Clients with Personality Disorders
Therapy for Clients with Personality Disorders

Paranoid Personality Disorder and the DSM-5-TR Diagnostic Criteria

Paranoid personality disorder (PPD) is in Cluster A of personality disorders, which entails odd or eccentric reasoning approaches. PDD occurs when a person demonstrates a pervasive pattern of suspecting others and perceiving them as spiteful. Consequently, Individuals suffering from PPD frequently assume that other people intend to harm or deceive them and cannot confide in other individuals or develop a trusting relationship (Jia, 2023).Generally, PDD patients experience unrelenting paranoia and no concrete reason (Therapy for Clients).

The disorder typically starts in early adulthood and is more common in men than women. Per the DMS-5 criteria, individuals with PDD tend to be hypervigilant to other people’s physical, verbal, or social attacks and never develop trust, hence having few close friends or intimate partners. The pervasive suspicion of others makes them argumentative, distant, aloof, and constant complainants.

These individuals are highly guarded and secretive, appear unemotional, hostile, rigid, and tend to employ sarcasm (Bhandari, 2022). Conclusively, getting along with people, engaging in group activities, or collaborative projects can be challenging with PDD. More so, because these individuals are highly critical of others but fail to take criticism well. Hence, becoming overly defensive and hostile.

Therapeutic Approach and Modality

Individuals with PDD are less likely to seek treatment because they fail to see the problem in them or their role in problems. However, psychotherapy is the first line of treatment if a person seeks treatment. Specifically, the behavioral therapeutic approach is more appropriate as it focuses on behavior and thought patterns impacting an individual’s behavior. As a therapist, this approach would be effective in helping the client find the cause of the symptoms. In addition, ways to relieve the symptoms (Nakao et al., 2021).
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The approach delves into helping the client recognize the symptoms when they occur the associated thinking patterns. Furthermore, what alternative thoughts can create new, positive feelings. Moreover, the therapeutic modality suitable for this case is cognitive behavioral therapy (CBT), the first treatment option for personality disorders, including PDD. A case study by Fard and Rad (2019) revealed that CBT can effectively treat PDD.

In this case, I would focus on helping the individual develop appropriate coping skills and improve social interaction, communication skills, and self-esteem. Ideally, therapists work closely with the client to identify situations or variables that trigger distrust, fear, and paranoia and develop a plan to help minimize paranoid thoughts and elevate the quality of life.

The primary focus is on harmful thinking patterns, and CBT has indicated effectiveness in helping PDD patients trust others, regulate their emotions, and improve social interactions. Depending on the patient’s needs, it can also be adopted in an individual or group setting (Fard & Rad, 2019). Group or family settings are preferable when the primary focus is helping the patient interact with others by participating in a behavioral experiment (Therapy for Clients).

Therapeutic Relationship

A therapeutic relationship is a close and consistent engagement or association between the therapist and the patient or group of patients, which aims to help individuals improve their lives (Bolsinger et al., 2020). Therefore, a therapist must develop a therapeutic relationship to deal with PDD patients because, without trust, it would be impossible to engage the client. Moreover, the therapist should be sensitive to the client’s intimate thoughts, beliefs, and emotions surrounding the disorder and develop a safe, open, and non-judgmental space when communicating with the client about the diagnosis, given that PDD clients distrust others and do not take well criticism or judgment.
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The therapist must also establish trust, respect, and congruence to establish and maintain the therapeutic relationship, even when communicating the diagnosis. It is easier to share information about the diagnosis in an individual setting because the client is confident it will remain private and confidential, especially with this diagnosis. First, I would ask the patient if he would like me to explain the diagnostic results. If the patient accepts, I will share the information cautiously, slowly, and clearly, recognizing their concerns, emotions, and feelings (Bolsinger et al., 2020).

In a group setting, the patient has the right to dictate whether other people should know about the diagnosis. Therefore, I would validate the concerns and ask the patient if he wants others to know. If the patient accepts, I will establish a considerate, trusting, and non-judgmental group atmosphere that accepts what others are going through (Jia, 2023). Sometimes patients do not want the family to know, and asking whether the information should be shared with the family is cautious and professional. If yes, the family should be invited to a session with the client, and the information should be communicated openly and without filters (Therapy for Clients).


Personality disorders impact functionality, making it hard for individuals to develop social relationships. For instance, paranoid personality disorder causes people to pervasively suspect others and perceive others as intending to harm them, physically or verbally. Diagnosis should follow the DMS-5 criteria, and treatment should consider the patient’s needs. The patient has a right to dictate how information about the diagnosis should be disclosed. Furthermore, to whom, and engaging the patient in this decision is professional (Therapy for Clients).

Review of Scholarly Sources

Scholarly sources used include Fard and Rad (2019), Jia (2023), Berichon et al. (2019), Nakao et al. (2021), and Bolsinger et al. (2020). These sources are peer-reviewed, and published in peer-reviewed journals, implying they are scholarly. The sources are also reliable because they are written by experts and professionals in the field of psychology, well-versed with the topic, and affiliated with medical institutions like universities and medical departments, including the Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland, University of Tehran, Beijing Huijia Private School, Department of Adult Psychiatry, Psychiatrie Baselland, Liestal, Switzerland, Bronson School of Nursing, Western Michigan University, Kalamazoo, Michigan, USA.
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Berichon, M., Birgy, T. R., Konrath, C. M., & Abraham, S. P. (2019). Challenges of Treatment and Living with the Stigma Related to Paranoid Personality Disorder. International Journal of Science and Research Methodology, 273-284.

Bhandari, S. (2022, August 25). Paranoid personality disorder. WebMD.

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.

Fard, M. K., & Rad, M. H. (2019). Cognitive-behavioral therapy of paranoid personality disorder; a case study.   

Jia, Y. (2023). General overview of paranoid personality disorder. Lecture Notes in Education Psychology and Public Media2(1), 355-360.

Nakao, M., Shirotsuki, K., & Sugaya, N. (2021). Cognitive-behavioral therapy for managing mental health and stress-related disorders: Recent advances in techniques and technologies. BioPsychoSocial medicine15(1), 16.

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