Is cognitive therapy suitable for treating individuals with personality dysfunction?

In this study, the impact of personality dysfunction on suitability for cog nitive therapy was examined empirically. Thirty-six (36) mental health outp atients were evaluated with regard to the extent of personality dysfunction and suitability for short-term cognitive therapy. All participants were in terviewed by a psychiatrist using the Personality Disorders Examination (PD E) to assess personality dysfunction, and by a psychologist using the Suita bility for hort-Term Cognitive Therapy Scale (SSCT) to assess cognitive the rapy suitability. Participants also completed the Millon Clinical Multiaxia l Inventory-Revised (MCMI-II) to provide a multimethod assessment of person ality dysfunction. Analysis of the correlations between suitability for cog nitive therapy and personality dysfunction for both the independent-intervi ewer rated method (the PDE) and the self-report method (MCMI-II) indicated that greater dysfunction was significantly associated with poorer suitabili ty for cognitive therapy. Results were most clear for the general therapy s ubscale of the SSCT relative to the cognitive therapy specific subscale. A tentative item analysis of the SSCT scale indicated that alliance potential (both in-session and out-of-session ratings), security operations, chronic ity, personal responsibility for change, and compatibility with the cogniti ve therapy rationale were most strongly affected (negatively) by personalit y dysfunction. These data suggest that, although personality dysfunction ha s an impact on suitability, cognitive therapy may not be any more contraind icated than any other form of psychotherapy. Theoretical developments withi n cognitive therapy to address personality dysfunction specifically also su pport the use of cognitive therapy with this population. Suggestions for sp ecific process and procedural modifications to cognitive therapy when worki ng with personality dysfunction that address the factors that contribute to poor suitability are outlined.