Evidence-Based Treatments for Personality Disorders

Treating personality disorders often requires more than insight, symptom management, or discussion of what happened between sessions. Long-standing beliefs and coping patterns can shape emotion regulation, relationships, treatment engagement, and the therapeutic relationship itself, while progress may be gradual and uneven. Clinicians need a coherent way to understand what is maintaining the presentation, choose realistic targets, balance validation with change, and respond when the same patterns emerge in the room.

Designed for licensed and pre-licensed behavioral health professionals who work with complex personality presentations, this training offers an integrated DBT, CBT, and schema-focused framework drawn from evidence-supported approaches. The emphasis is on organizing treatment around a clear conceptualization, matching intervention depth to the client’s needs and readiness, and maintaining realistic expectations about safety, comorbidity, available resources, and the extended course of care often required for deeper change.

Jeff Riggenbach, Ph.D., brings more than two decades of experience treating personality disorders in inpatient and outpatient settings. His specialized preparation includes a three-day staff training led by Marsha Linehan, postdoctoral training at the Beck Institute with Aaron Beck, Judith Beck, and Leslie Sokol, and schema therapy training through the Midwest Schema Therapy Institute. He also helped develop an integrated treatment program that has served more than 500 people with borderline personality disorder, along with clients with other personality presentations, and has trained clinicians in all 50 states and nine countries. This combination of formal training, program development, and direct clinical work informs the practical treatment framework presented here.

Through case examples, client worksheets, and structured treatment tools, the material is translated into practical applications for individual and group settings. Clinicians are encouraged to view difficult behaviors as understandable products of schemas, learning histories, and current contexts, recognize incremental progress, and use validation, collaboration, boundaries, and carefully timed here-and-now observations without reinforcing the cycles treatment is intended to change.

The course examines how DBT skills, standard CBT interventions, and schema modification can be sequenced from behavioral stabilization to deeper belief change. Collaborative conceptualization maps connect significant experiences, schemas, present-day triggers, and target behaviors so treatment planning, session focus, and documentation follow a coherent clinical rationale. Examples across a range of personality presentations—including more detailed work with borderline and narcissistic patterns—show how interventions can be adapted to functioning, readiness, setting, available resources, and pace of change, while relapse-prevention, booster-session, and self-therapy planning support a more deliberate transition out of regular treatment.

Key Takeaways:

• Evidence-informed treatment choices: Clarify what the research does and does not establish about supported approaches and how DBT, CBT, and schema-focused strategies can serve different treatment purposes.
• Conceptualization that directs care: Link significant experiences, beliefs, triggers, behaviors, and goals in a practical formulation that guides priorities, agenda setting, intervention, and documentation.
• Planning for sustained gains: Use relapse-prevention, booster-session, and self-therapy strategies to help clients recognize warning signs, continue practicing skills, and approach the end of treatment more deliberately.

Why this course?

• A realistic approach to complex change: Understand why progress may be incremental, why deeper schema work takes time, and how to recognize meaningful improvement without overstating outcomes.
• The relationship as a treatment setting: Learn to address interpersonal patterns as they appear with the clinician while balancing validation, boundaries, collaboration, and change.
• Experience translated into usable tools: Applied examples and worksheets drawn from extensive inpatient and outpatient work help connect the framework to individual and group practice.

Learning Objectives:

• Discuss 8 evidence-based treatments for personality disorders.
• Describe 5 characteristics unique to treating these diagnoses effectively.
• Explain 18 early maladaptive schemas driving target behaviors, including historical, cultural, and other environmental risk factors influencing them.
• Design case conceptualization diagrams to drive treatment planning, agenda setting, and documentation.
• Describe 3 schema modes in narcissism and design mode work strategies.
• Compare the 2 types of relapse prevention sessions with the typical course of care sessions.

Register to strengthen your ability to organize treatment for personality disorders around a clear conceptualization, select interventions that fit the client’s needs and readiness, and respond more deliberately when entrenched patterns emerge in and outside the therapy room. The framework and tools can support more focused, realistic, and collaborative care across the course of treatment.