Personality-Disordered Patients: Treatable and Untreatable

by Michael H. Stone

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Author: Michael H. Stone

Publisher: American Psychiatric Publishing, Inc.

Paperback:
ISBN 10: 1585621722
ISBN 13: 978-1585621729

Determining the amenability of personality disorders to psychotherapy -- a patient's capacity to benefit from verbal approaches to treatment -- is important in helping clinicians determine the treatability of cases. Michael Stone here shares the factors he has observed over long years of practice that can help practitioners evaluate patients, stressing the amenability of the various disorders to amelioration. By focusing on which patients are likely to respond well to therapeutic intervention and which will prove most resistive, his book will help therapists determine with what kinds of patients they will most likely succeed and with which ones failure is almost a certainty.

Stone establishes the attributes that affect this amenability -- such as the capacity for self-reflection, motivation, and life circumstances's guidelines for evaluating patients, then describes borderline and other personality-disordered patients with varying levels of amenability, from high to low. This coverage progresses from patients belonging to the DSM "anxious cluster," along with the depressive-masochistic character and the hysteric character, to patients who demonstrate an intermediate level of amenability to psychotherapy. He introduces the interrelationship between borderline personality disorder and dissociative disorders and discusses treatability among certain patients in Clusters "A" and "C," as well as others with narcissistic, histrionic, depressive disorders. Final chapters address the most severe aberrations of personality and the limitations they impose on the efficacy of therapy. Personality-Disordered Patients is filled with practical, clinically focused information. This guideline structured book:

Covers all personality disorders-including ones not addressed in the latest DSM such as sadistic, depressive, hypomanic, and irritable-explosive
Identifies both attributes necessary for treatability and factors associated with low treatability
Pays particular attention to borderline disorders, which represent the most discussed conditions and are among the most challenging to psychotherapists
Reviews personality traits whose presence, if intense-even if unaccompanied by a definable personality disorder-creates severe problems for psychotherapy

Numerous case studies throughout the book provide examples that will help therapists determine which of their own patients are most likely to benefit from their efforts and thereby establish their own limits of effectiveness. By alerting practitioners to when therapy is likely to fail, these guidelines can help them avoid the professional disappointment of being unable to reach the most intractable patients.

Review

In this very well-written and clinically rich text, Personality-Disordered Patients: Treatable and Untreatable, Stone approaches the treatability of personality-disordered patients, from most amenable to untreatable, across 11-at times, interrelated-factors or dimensions.... The greatest strength of Personality-Disordered Patients: Treatable and Untreatable lies in its vast clinical richness and the fact that the information contained within will be useful to mental health professionals from all schools of thought. Clinical vignettes constitute probably more than half the text and beautifully and poignantly illustrate the technical points being made during each phase of the book, which is a pleasure to read.

-- (06/21/2006)

[Personality-Disordered Patients] is enjoyable, readable, and informative. We are invited in for a glimpse of Michael Stone's many therapeutic encounters and learn from his broad range of experience. His organizing the book along the lines of amenability to treatment is useful, and his tables of traits and characteristics can help clinicians evaluate prognosis and course, and can provide comfort to therapists who are having difficulty understanding what is going on their therapists with personality-disordered- patients.

-- (06/21/2006)

Personality-Disordered Patients is a terrific book for clinicians. It is well written with multiple clinical vignettes. I would highly recommend this book to all clinicians who work with challenging patients.

-- (06/21/2006)

From the Inside Flap

Taking in the entire spectrum of personality disorders -- from the DSM "Anxious Cluster" to antisocial personality disorder -- this book offers practical guidance for assessing the amenability of patients to psychotherapy. By focusing on which patients are likely to respond well to therapeutic intervention and which will prove most resistive, Personality Disordered Patients: Treatable and Untreatable can assist clinicians in determining with what kinds of patients they will most likely succeed and with which ones failure is almost a certainty.

Michael Stone establishes the attributes that affect this amenability -- such as self-reflection, motivation, and life circumstances -- as guidelines for evaluating patients, then describes borderline and other personality-disordered patients with varying levels of symptoms, from mild to severe. Sharing observations from many years of practice, he identifies factors associated with low treatability and reviews personality traits whose presence, if intense -- even if unaccompanied by a definable personality disorder -- creates severe problems for psychotherapy. Numerous case studies provide examples that will help clinicians determine which of their patients are most likely to benefit from their efforts and thereby establish their own limits of effectiveness.

About the Author

Michael H. Stone, M.D., is Professor of Clinical Psychiatry at Columbia College of Physicians and Surgeons.

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Personality-Disordered Patients: Treatable and Untreatable