We tend to think of CBT as a short-term, symptom-focused treatment—so how can we apply it to clients with deep-seated personality disorders? Prepare to have your clinical horizons broadened in this video with Art Freeman, who demonstrates classic CBT with a refreshing, world-wise simplicity while integrating skills and techniques from other approaches. Here, Freeman illustrates how attention to client schemas, cognitions, and the therapeutic alliance can be integrated into a full course of treatment for Axis II conditions, and offers a real contrast to traditional views of CBT.
Alfred, ambivalent about therapy and emotionally disturbed, comes to Freeman after the latest in a string of unexpected relationship breakups struggling with feelings of anger, blame and suicidality. At first believing Alfred to be overly dependent, Freeman uncovers narcissistic beliefs, substance abuse, and physical violence that point to a more troubling personality disorder. Honing in on Alfred’s maladaptive schemas—or core beliefs regarding relationships—he asks direct questions that challenge Alfred’s perceptions, while maintaining an attuned and nonjudgmental stance.
Freeman offers informative commentary throughout two full sessions, giving us insight into his thought process and rationale for specific interventions. The use of metaphor plays prominently in his work, and helps Alfred make sense of his experience in a way that eases his fragile self-concept and builds trust. Plain-spoken and practical, Freeman guides the sessions toward concrete goals while highlighting the cognitions that threaten to impede the work for this “scary” client. By the end of the video, Alfred has committed to further therapy and finds hope at the prospect of gaining control over his life.
A wonderful cap to our series, this video is a must-see if you’re interested in CBT, personality disorders, assessment, or weaving together different clinical perspectives.
This video is part of the 3-video series, 3 Approaches to Personality Disorders. Other videos in this series include:
- CBT for Personality Disorders
- Dialectical Behavioral Therapy
- Psychoanalytic Psychotherapy
