Therapist's Guide to Clinical Intervention - Sigmund Freud

AVOIDANT PERSONALITY DISORDER
Goals 1. Decrease resistance to beneficial intervention/change
Treatment Focus
and Objectives
2. Develop goals
3. Improve social interaction
4. Decrease avoidant behavior
5. Resolve issues of loss
6. Improve coping skills
7. Cognitive restructuring
8. Decrease sensitivity
9. Improve self-esteem
1. Therapeutic Resistance
A. Establish a trusting therapeutic relationship
B. Do not engage the person in clinical issues too quickly
C. Do not pressure the person with expectations
2. Lack of Goals
A. Develop appropriate goals for personal growth and behavioral change
3. Impaired Social Interaction
A. Facilitate identification of fears (rejection, etc.) and feeling that the environment is
unsafe
B. Educate regarding effect of anxiety in avoidant behavior
C. Facilitate identification of realistic expectations regarding changes in avoidant
behavior
D. Develop a slow-paced stepwise progression of social interaction
E. Facilitate identification of fear of rejection and hypersensitivity. Increase awareness
of alternative ways of viewing the responses of others versus personalizing.
F. Refer to group therapy to increase awareness for and practice dealing with
hypersensitivity
G. Facilitate small steps toward calculated risks for social/personal gratification
H. Positive feedback and reinforcement for efforts and accomplishments
4. Avoidance of People and Situations
A. Systematic desensitization/flooding
B. Teach assertive communication
1. Role-play and model effective, honest responses/behaviors
C. Break down desired behavioral changes into manageable steps
D. Be supportive, focusing on positives
E. Positive feedback and reinforcement for efforts and accomplishments
5. Issues of Loss
A. Facilitate identification of feelings of loneliness, being an outsider, and so forth
B. Identify behaviors that contribute to isolation and aloneness
C. Facilitate resolution of losses through venting of feelings, closure on issues where
appropriate, problem solving, and behavioral changes
6. Ineffective Coping
A. Establish a trusting relationship, reciprocating respect by keeping appointments,
being honest, genuine, and so on within the therapeutic frame
Personality Disorders 89