Abstract
This article presents single-subject data for the treatment of histrionic and narcissistic personality disorder behaviors using a relatively brief course of an interpersonal therapy, Functional Analytic Psychotherapy (Kohlenberg & Tsai, 1991). The treatment produced significant changes in these behaviors both statistically and qualitatively. Empirical methods for analyzing the changes across sessions and for determining that the therapist engaged in the proposed mechanism of clinical change are discussed. While these data are for one subject, the results of treatment provide both a method of treating difficult and long-standing client behaviors such as these, and for assessing the progress of therapy.
Similar content being viewed by others
References
Adler, G. (1986). Psychotherapy of the narcissistic personality disorder patient: Two contrasting approaches. American Journal of Psychiatry, 143, 430–436.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, (fourth ed.). Washington, DC: Author.
Andrews, J. D. (1984). Psychotherapy with the hysterical personality: an interpersonal approach. Psychiatry, 47, 211–32.
Bakeman, R., & Gottman, J. M. (1986). Observing interaction: An introduction to sequential analysis. New York: Cambridge Press.
Bateman, A. W., & Fonagy, P. (2000). Effectiveness of psychotherapeutic treatment of personality disorder. British Journal of Psychiatry, 177, 138–143.
Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 53–63.
Benjamin, L. S. (1996). Interpersonal diagnosis and treatment of personality disorders (2nd ed.). New York: The Guilford Press.
Callaghan, G. M. (1998). Development of a coding system for functional analytical psychotherapy for the analysis of the components effecting clinical change. Dissertation Abstracts International, 59(09), 5073B. (UMI No. 9907753)
Callaghan, G. M. (2001). The Functional Idiographic Assessment Template: The FIAT System. Unpublished manual, San Jose State University.
Callaghan, G. M., Linnerooth, P. J., Ruckstuhl, L. E., & Follette, W. C (2002). Measuring the Cause of Clinical Change: An Analysis of the Functional Analytic Psychotherapy Rating Scale. Manuscript submitted for publication.
Callaghan, G. M., Naugle, A. E., & Follette, W. C. (1996). Useful constructions of the client-therapist relationship. Psychotherapy, 33, 381–390.
Callaghan, G. M., Summers, C. J., & Weidman M. (2001, May). A more person-focused approach to assessing client behaviors: Development of the Functional Idiographic Assessment Template. Paper presented at the 81st Annual Meeting of the Western Psychological Association, Maui, HI.
Chambless, D. L., & Ollendick, T. H. (2000). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716.
Ellis, M. V., Ladany, N., Krengel, M., & Schult, D. (1996). Clinical supervision research from 1981 to 1993: A methodological critique. Journal of Counseling Psychology, 43, 35–50.
Follette, W. C., Naugle, A. E., & Callaghan, G. M. (1996). A radical behavioral understanding of the therapeutic relationship in effecting client change. Behavior Therapy, 27, 623–641.
Gottman, J. M., & Roy, A. K. (1990). Sequential analysis: A guide for behavioral researchers. New York: Cambridge Press.
Hingley, S. M. (2001). Psychodynamic theory and narcissistically related personality problems: Support from case study research. British Journal of Medical Psychology, 74, 57–72.
Horowitz, M. J. (1997). Psychotherapy for histrionic personality disorder. Journal Psychotherapy Practice and Research, 6, 93–107.
Kazdin, A. E. (1994). Methodology, design, and evaluation in psychotherapy research. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (Fourth ed., pp. 19–71). New York: Wiley.
Kernberg, O. (1980) Internal world and external reality. New York: Jason Aronson Publishers.
Klein, D. N., & Miller, G. A. (1997). Depressive Personality: Relationship to Dysthymia and Major Depression. In H. S. Akiskal & G. B. Cassano, (Eds.), Dysthymia and the Spectrum of Chronic Depressions, (pp. 87–95). New York: Guilford Press.
Koerner, K., Kohlenberg, R. J., & Parker, C. R. (1996). Diagnosis of personality disorder: A radical behavioral alternative. Journal of Consulting and Clinical Psychology, 64, 1169–1176.
Kohlenberg, R. J., Hayes, S. C., & Tsai, M. (1993). Radical behavioral psychotherapy: Two contemporary examples. Clinical Psychology Review, 13, 579–592.
Kohlenberg, R. J., & Tsai, M. (1991). Functional analytic psychotherapy: Creating intense and curative therapeutic relationships. New York: Plenum.
Kohlenberg, R. J., & Tsai, M. (1995). I speak therefore I am: A behavioral approach to understanding problems of the self. The Behavior Therapist, 18, 113–116.
Kohut, H. (1977). The restoration of the self. New York: International University Press.
Kraus, G., & Reynolds, D. J. (2001). The “A-B-C'S” of the cluster B's: Identifying, understand, and treating cluster B personality disorders. Clinical Psychology Review, 21, 345–373.
Linehan, M. M. (1993). Cognitive behavioral therapy of borderline personality disorders. New York: Guilford Press.
McNeal, S. (2003). A character in search of character: Narcissistic personality disorder and ego state therapy. American Journal of Clinical Hypnosis, 45, 233–234.
Morey, L. C. (1988). Personality disorders in DSM-III and DSM-III-R: convergence, coverage, and internal consistency. American Journal of Psychiatry, 145, 573–577.
Nelson-Gray, R. O., & Farmer, R. F. (1999). Behavioral assessment of personality disorders. Behaviour Research and Therapy, 37, 347–368.
Nurnberg, H. G. (1984). Survey of psychotherapeutic approaches to narcissistic personality disorder. Hillside Journal of Clinical Psychiatry, 6, 204–20.
Perry, J. C., Banon, E., & Ianni, F. (1999). Effectiveness of psychotherapy for personality disorders. American Journal of Psychiatry, 156, 1312–1321.
Turner, R. M. (1994). Borderline, narcissistic, and histrionic personality disorders. In M. Hersen & R. T. Ammerman (Eds.), Handbook for prescriptive treatments for adults, (pp. 393–420). New York: Plenum.
Rivas, L. A. (2001). Controversial issues in the diagnosis of narcissistic personality disorder: A review of the literature. Journal of Mental Health Counseling, 23, 22–35.
Westen, D. (1997). Divergences between clinical and research methods for assessing personality disorders: implications for research and the evolution of axis II. American Journal of Psychiatry, 154, 895–903.
Westen, D., & Shedler, J. (1999a). Revising and assessing Axis II, part I: Developing a clinically and empirically valid assessment method. American Journal of Psychiatry, 156, 258–272.
Westen, D., & Shedler, J. (1999b). Revising and assessing Axis II, part II: Toward an empirically based and clinically useful classification of personality disorders. American Journal of Psychiatry, 156, 273–285.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Callaghan, G.M., Summers, C.J. & Weidman, M. The Treatment of Histrionic and Narcissistic Personality Disorder Behaviors: A Single-Subject Demonstration of Clinical Improvement Using Functional Analytic Psychotherapy. Journal of Contemporary Psychotherapy 33, 321–339 (2003). https://doi.org/10.1023/B:JOCP.0000004502.55597.81
Issue Date:
DOI: https://doi.org/10.1023/B:JOCP.0000004502.55597.81