Fox - Antisocial, borderline, narcissistic & histrionic workbook: treatment strategies for cluster B personality disorders

Personality disorders are common in clinical practice, but helpful resources are not. Dr. Fox answers the call with a workbook that will deepen your understanding of the assessment and treatment of Cluster B personalities, with a dedicated emphasis on handouts and worksheets that guide therapy and provide a catalyst for change. Enthusiastically recommended!

-Lane Pederson, PsyD, LP, DBTC, author of
The Expanded Dialectical Behavior Therapy Skills Training Manual

Full of concrete tools to make successful progress in treatment! The research provides a great foundation for the use of the materials and Dr. Fox has pulled from multiple resources to create tools clinicians and clients can both use to promote wellness and growth. I have found that the use of the workbook can be applicable in nearly every session I have with someone battling with a Cluster B personality disorder. After applying the concepts in this workbook I have found that Cluster B clients are not the same beasts in treatment that they were in the past.

-Susan Barris, PhD

Insightful for the therapist and easy-to-use with clients. The worksheets are very effective in assisting with a more accurate diagnosis of Cluster B personality types and, even more importantly, understanding the therapists own responses to the client. This workbook is also helpful when needing to incorporate more tangible and structured treatment approaches into therapy. The DBT worksheets are easy to follow and use client friendly language and concepts.

-Meagan N. Houston, PhD

The collection of exercises for the clinician and the client are practical, useful, and empirically driven. This is a well written, easy to read, and thorough guide providing a framework and a level of confidence for the clinician facing the challenges of treating severe personality disorders.

-Kristy Dromgoole, PhD

This rich resource assists the clinician in avoiding errors in diagnosis that can often occur when working with clients with complex symptom presentations. Dr. Fox presents the material in a straightforward, easy to digest, manner that can be appreciated and utilized by all practitioners. Clinicians, regardless of their training background or theoretical orientation, will find this to be an invaluable resource in the diagnosis and treatment of Cluster B personality disorders.

-Mary Madison Eagle, PhD

Dr. Fox's passion for this subject shines through in the workbook format. This workbook can serve as both a reference and a helpful tool for gathering information. Dr. Fox's style of writing is clear and concise. I was able to take in the information quickly and see how useful the worksheets could be.

-Kristin A. Lue King, MSW

Copyright 2015 by Daniel J. Fox, Ph.D.

Published by

PESI Publishing & Media

PESI, Inc

3839 White Ave

Eau Claire, WI 54703

Cover: Amy Rubenzer

Editing: Blair Davis

Layout: Bookmasters & Amy Rubenzer

ISBN: 9781559570183

All rights reserved.

Printed in the United States of America.

Library of Congress Cataloging-in-Publication Data

Fox, Daniel J., Psychologist.

Antisocial, borderline, narcissist & histrionic workbook : treatment strategies for cluster B personality disorders / Daniel J Fox, Ph.D.

pages cm

Includes bibliographical references.

ISBN 978-1-55957-018-3

1. Personality disorders. 2. Personality disorders--Treatment. I. Title. II. Title: Antisocial, borderline, narcissist and histrionic workbook.

RC554.F69 2015

616.85'81--dc23

2015029495

This book is dedicated to my three heartbeats: my wife, Lydia, and my two children,Alexandra and Sebastian.

About the Author

Daniel J. Fox, Ph.D., has been specializing in the treatment and assessment of individuals with personality disorders for more than 16 years in the state and federal prison system, universities, and private practice. He is a licensed psychologist in the state of Texas and author of The Clinician's Guide to The Diagnosis and Treatment of Personality Disorders and several articles on personality, ethics, and neurofeedback. His specialty areas include personality disorders, ethics, and emotional intelligence. Dr. Fox has been teaching and supervising students for the past 13 years at various universities across the country, including West Virginia University, Texas A&M University, University of Houston, Sam Houston State University, and Florida State University.

He is currently a staff psychologist at the Federal Detention Center in Houston, Texas, and Adjunct Assistant Professor at University of Houston. He also maintains a private practice that specializes in assessment and treatment of difficult clients. Dr. Fox has given numerous workshops and seminars domestically and internationally on ethics and personality disorders, personality disorders and crime, emotional intelligence, burnout prevention, managing mental health within the prison system, and other related topics.

For more information on Dr. Fox, visit his website at www.drdfox.com.

Who This Workbook Is For and How to Use It

Many clinicians feel confused by or helpless in the face of the severe pathology associated with antisocial, narcissistic, histrionic, and borderline personality disordered clients. These four disorders make up Cluster B of the personality disorders in the Diagnostic and Statistical Manual of Mental Disorders, currently in its fifth edition (American Psychiatric Association [APA], 2013). The reason these four disorders are contained within a cluster is due to overlap in symptoms and presentation. This overlap further confounds treatment for the frontline clinician, as symptoms are expressed from various aspects of the pathology along a spectrum. Most clients are at different points on the spectrum and will not meet criteria for the full disorder. For example, many clients will display borderline personality disorder traits but not to the extent to merit the full diagnosis. This workbook is designed to treat individuals who meet full criteria as well those who display traits and are on the spectrum of any of the Cluster B disorders.

Due to the inherent complexity of the presentation of such disorders, there are multiple approaches a clinician can use to attenuate symptomatology. This workbook is designed to provide assistance to the frontline clinician who may be stuck or feel that he or she is out of options when working with this complex group of individuals. The workbook pulls from multiple therapeutic modalities that include interpersonal, object relations, cognitive-behavioral, and Dialectical Behavioral Therapy.

The first section provides useful tools and information on antisocial, narcissistic, histrionic, and borderline personality disorders that can aid in directing treatment, identifying risk and protective factors, and determining which Cluster B personality disorders or traits are present. The remaining parts of the workbook contain detailed worksheets and exercises for each of the four Cluster B spectrums. Due to the overlap in symptoms across the four disorders, many of the worksheets and exercises can be useful for individuals who have traits on more than one spectrum. For example, a client who has comorbid traits along the borderline and antisocial spectrums would benefit from worksheets and exercises from both of these sections.