Abstract
Clarification-oriented psychotherapy, an integrative form of psychotherapy for dependent personality disorder, is presented. Based on a generic theoretical model, a specific model of the psychological functioning of dependent personality disorder is developed. This model serves as a rationale to developing therapeutic intervention strategies aiming at addressing the specific problems related with the disorder. Special therapeutic problems which may occur in the process are discussed. The theoretical elaboration is illustrated by means of a clinical case presenting with dependent personality disorder.
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Agrawal, K., & Rai, S. N. (1988). Post-noise frustration-tolerance as a function of controllability of noise and dependence-proneness. Indian Journal of Psychometry and Education, 19, 85–89.
Bamelis, L. L. M., Evers, S. M., Spinhoven, P., & Arntz, A. (2014). Results of a multicenter randomized controlled trial of thze clinical effectiveness of schema therapy for personality disorders. American Journal of Psychiatry, 171, 305–322. https://doi.org/10.1176/appi.ajp.2013.12040518.
Barzega, G., Maina, G., Venturello, S., & Bogetto, F. (2001). Gender-related distribution of personality disorders in a sample of patients with panic disorder. European Psychiatry, 16, 173–179.
Beck, A. T. (1979). Wahrnehmung der Wirklichkeit und Neurose. München: Pfeiffer.
Beckmann, J. (2006). Konsequenzen der Entfremdung vom Selbst. In R. Sachse & P. Schlebusch (Hrsg.), Perspektiven Klärungsorientierter Psychotherapie (pp. 46–59). Lengerich: Pabst.
Bornstein, R. F. (1993). The dependent personality. New York: Guilford.
Bornstein, R. F. (1995). Comorbidity of dependent personality disorder and other psychological disorders: An integrative review. Journal of Personality Disorders, 9(4), 286–303.
Bornstein, R. F. (1996). Sex differences in dependent personality disorder prevalence rates. Clinical Psychology: Science and Practice, 3(1), 1–12.
Bornstein, R. F. (1997). Dependent personality disorder in the DSM-IV and beyond. Clinical Psychology, Science and Practice, 4, 175–187.
Bornstein, R. F. (1998). Depathologizing dependency. The Journal of Nervous and Mental Disease, 186(2), 67–73.
Bornstein, R. F., & Masling, J. M. (1985). Orality and latency of volunteering to serve as experimental subjects: A replication. Journal of Personality Assessment, 49, 306–310.
Caspar, F. (1996). Beziehungen und Probleme verstehen. Eine Einführung in die psychothe-rapeutische Plananalyse. Zweite überarbeitete Auflage. Bern: Huber.
Conley, J. J. (1980). Family configuration as an etiological factor in alcoholism. Journal of Abnormal Psychology, 89, 670–673.
Dollard, J., & Miller, M. E. (1950). Personality and Psychotherapy. New York: McGraw Hill.
Elliott, R., Greenberg, L. S., Watson, J., Timulak, L., & Freire, E. (2013). Research on humanistic-experiential psychotherapies. In M. J. Lambert (Ed.), Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change. Sixth Edition (pp. 495–538). Hoboken: John Wiley and Sons.
Grawe, K. (1998). Psychological Therapy. Göttingen: Hogrefe.
Griffith, C. E. (1991). Personality and gender as factors in interpersonal negotiation. Journal of Social Behavior and Personality, 6, 915–928.
Jackson, H. H., Whiteside, W. L., Bates, G. W., Bell, R., Rudd, R. P., & Edwards, J. (1991). Diagnosing personality disorders in psychiatric outpatients. Acta Psychiatrica Scandinavica, 83, 206–213.
Kramer, U., Pascual-Leone, A., Rohde, K. N., & Sachse, R. (2016). Emotional processing, interaction process and outcome in clarification-oriented psychotherapy for personality disorders: A process-outcome analysis. Journal of Personality Disorders, 30(3), 373–394.
Kramer, U., Pascual-Leone, A., Rohde, K. B., & Sachse, R. (2018). The role of shame and self-compassion in psychotherapy for narcissistic personality disorder: An exploratory study. Clinical Psychology and Psychotherapy, 25, 272–283. https://doi.org/10.1002/cpp.2160.
Kuhl, J., & Beckmann, J. (1994). Alienation: Ignoring one`s preferences. In J. Kuhl & J. Beckmann (Eds.), Volition and Personality: Action versus state orientation (pp. 375–390). Göttingen: Hogrefe.
Loas, G., & Cormier, J. (2008). Dependent personality disorder and alexithymia. [French] Alexithymie et personnalité dépendante: Etude de la stabilité de l’association sur une période de trois mois dans un groupe de 184 sujets. Annales Medico-Psychologiques, 166(5), 361–365.
Loranger, A. W. (1996). Dependent personality disorder: Age, sex, and Axis I comorbidity. Journal of Nervous and Mental Disease, 184, 17–21.
Main, M., Kaplan, N., & Cassidy, J. (1985). Security in infancy, childhood and adulthood. Monographs of the Society for Research in Child Development, 50, 66–104.
Millon, T. (2011). Disorders of personality. New York: Wiley.
Millon, Th (1996). Disorders of Personality. DSM IV and Beyond. New York: Wiley.
Norman, D. A. (1982). Learning and memory. San Francisco: Freeman.
Overholser, J. C. (1996). The dependent personality and interpersonal problems. The Journal of Nervous and Mental Disease, 184(1), 8–16.
Power, M. J., & Dalgleish, T. (1997). Cognition and emotion: From order to disorder. Hove: Psychology Press.
Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21, 95–103.
Rost, K. M., Akins, R. N., Brown, F. W., & Smith, G. R. (1992). The comorbidity of DSM-III-R personality disorders in somatization disorder. General Hospital Psychiatry, 14, 322–326.
Rumelhart, D. E. (1980). Schemata: The building-blocks of cognition. In R. Spiro, B. Bruce & W. Brewer (Eds.), Theoretical issues in reading comprehension. Hillsdale: Erlbaum.
Sachse, R. (1995). Der psychosomatische Klient in der Praxis: Grundlagen einer effektiven Therapie mit “schwierigen” Klienten. Stuttgart: Kohlhammer.
Sachse, R. (2003). Klärungsorientierte Psychotherapie. Göttingen: Hogrefe.
Sachse, R. (2005). Was wirkt in der Behandlung von Persönlichkeitsstörungen? In N. Saimeh (Hrsg.), Was wirkt? Prävention—Behandlung—Rehabilitation (pp. 222–229). Bonn: Psychiatrie-Verlag.
Sachse, R. (2006a). Persönlichkeitsstörungen verstehen—Zum Umgang mit schwierigen Klienten. Bonn: Psychiatrie-Verlag.
Sachse, R. (2006b). Therapeutische Beziehungsgestaltung. Göttingen: Hogrefe.
Sachse, R. (2008). Klärungsprozesse in der Psychotherapie. In J. Margraf & S. Schneider (Hrsg.), Lehrbuch der Verhaltenstherapie (3. Aufl., pp. 227–232). Berlin: Springer.
Sachse, R. (2013a). Komplementäre Beziehungsgestaltung: Plananalyse und Klärungsorientierte Psychotherapie. In H. Znoj & Th Berger (Hrsg.), Die Kunst und Wissenschaft der Psychotherapie (pp. 57–80). Bern: Huber.
Sachse, R. (2013b). Persönlichkeitsstörungen: Leitfaden für eine psychologische Psychotherapie (2. Aufl.). Göttingen: Hogrefe.
Sachse, R., Breil, J., Fasbender, J., Püschel, O., & Sachse, M. (2009). Was ist Klärungsorientierte Psychotherapie? In R. Sachse, J. Fasbender, J. Breil & O. Püschel (Hrsg.), Grundlagen und Konzepte Klärungsorientierter Psychotherapie (pp. 15–31). Göttingen: Hogrefe.
Sachse, R., Breil, J., Sachse, M., & Fasbender, J. (2013). Klärungsorientierte Psychotherapie der dependenten Persönlichkeitsstörung. Göttingen: Hogrefe.
Sachse, R., & Fasbender, J. (2010). Klärungsprozesse in der Psychotherapie. In W. Lutz (Hrsg.), Lehrbuch Psychotherapie (pp. 377–392). Bern: Huber.
Sachse, R., & Fasbender, J. (2014). Focusing: Die Repräsentation affektiver Bedeutungen. In R. Sachse & T. A. Langens (Hrsg.), Emotionen und Affekte in der Psychotherapie (pp. 156–178). Göttingen: Hogrefe.
Sachse, R., Fasbender, J., Breil, J., & Sachse, M. (2011). Bearbeitung von Schemata im Ein-Personen-Rollenspiel. In R. Sachse, J. Fasbender, J. Breil & M. Sachse (Hrsg.), Per-spektiven Klärungsorientierter Psychotherapie II (pp. 184–204). Lengerich: Pabst.
Sachse, R., Langens, T. A., & Sachse, M. (2012). Klienten motivieren—Therapeutische Strategien zur Stärkung der Änderungsbereitschaft. Bonn: Psychiatrie-Verlag.
Sachse, R., Püschel, O., Fasbender, J., & Breil, J. (2008). Klärungsorientierte Schema-Bearbeitung—Dysfunktionale Schemata effektiv verändern. Göttingen: Hogrefe.
Sachse, R., & Sachse, M. (2016). Effekte Klärungsorientierter Psychotherapie bei Klienten mit narzissistischer Persönlichkeitsstörung. In R. Sachse & M. Sachse (Eds.), Forschung in der Klärungsorientierten Psychotherapie[Research in clarification-oriented psychotherapy] (pp. 76–80). Lengerich: Pabst Science Publishers.
Sachse, R., Sachse, M., & Fasbender, J. (2010). Klärungsorientierte Psychotherapie von Persönlichkeitsstörungen. Göttingen: Hogrefe.
Sachse, R., & Takens, R. J. (2002). Klärungsprozesse in der Psychotherapie. Göttingen: Hogrefe.
Shilkret, C. J., & Masling, J. M. (1981). Oral dependence and dependent behavior. Journal of Personality Assessment, 45, 125–129.
Simpson, J. A., & Gangestad, S. W. (1991). Individual differences in sociosexuality: Evidence for convergent and discriminant validity. Journal of Personality and Social Psychology, 60, 870–883.
Sinha, B. K., & Watson, D. C. (2004). Personality disorder clusters and the Defence Style Questionnaire. Psychology and Psychotherapy: Theory, Research and Practice, 77(1), 55–66.
Sinha, B. K., & Watson, D. C. (2006). Hostility and personality disorder. Imagination, Cognition and Personality, 25(1), 45–57.
Soygüt, G., Nelson, L., & Safran, J. D. (2001). The relationship between patient pretreatment interpersonal schemas and therapeutic alliance in short-term cognitive therapy. Journal of Cognitive Psychotherapy, 15(1), 59–66.
Sroufe, L. A., Fox, N. E., & Pancake, V. R. (1983). Attachment and dependency in developmental perspective. Child Development, 54, 1615–1627.
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Sachse, R., Kramer, U. Clarification-Oriented Psychotherapy of Dependent Personality Disorder. J Contemp Psychother 49, 15–25 (2019). https://doi.org/10.1007/s10879-018-9397-8
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DOI: https://doi.org/10.1007/s10879-018-9397-8