Therapists' handling of patients with cluster B personality disorders in individual psychotherapy

Individual psychotherapy is a recommended treatment of patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, cluster B personality disorders. Due to their pathology, these patients represent a challenge in psychotherapy, and guidelines for practical handling exist. This study examined the attitudes of psychotherapists toward these challenges. Three hundred twenty-four experienced Norwegian therapists filled in a questionnaire on issues relevant to individual psychotherapy of patients with personality disorders. The attitudes toward cluster B patients were examined and compared with those of clusters A and C patients on contract issues, acting out, use of drugs, information to relatives, and contraindications. A considerable gap was found between therapists' attitudes toward cluster B patients and published guidelines. The therapists mostly handled cluster B in the same way as clusters A and C. Empirical investigations of therapists' handling provide an important feedback from everyday clinical practice on divergences in relation to guidelines derived from experts' consensus and research. (c) 2005 Elsevier Inc. All rights reserved.