UCH Psychiatry Outpatient Service
Personality Styles and Personality Disorders Specialty Clinic
The Personality Styles and Personality Disorders Specialty Clinic is open to all adult patients. The clinic accepts referrals from mental health professionals in the community and provides a gateway to comprehensive assessment and treatment.
About Personality Styles and Disorders
Psychological difficulties are often knit into the fabric of personality. The term personality refers to habitual patterns of thinking, feeling, behaving, coping with stress, and relating to others. Personality is formed by the interaction between our environment (how we are raised) and our genes. All people have personality traits. When personality traits become rigid and inflexible, then the person may have a personality disorder.
People with healthy personalities are able to engage in satisfying relationships, make good use of their talents and abilities, function relatively flexibly under stress, and neither experience excessive suffering nor impose it on others.
People with personality disorders have a more limited range of responses to other people and to life’s challenges. They may respond to stress in inflexible ways (for example, by always being logical and not acknowledging emotions), or they may find themselves getting into the same kinds of life difficulties time and again. Often, other people such as family, friends, or coworkers are the first to recognize personality problems.
There is no hard and fast dividing line between a normal personality trait and a personality disorder. It is a matter of degree. For example, a person who is suspicious when making business deals may simply be a good businessman. A person who is suspicious of everyone, everywhere may have a paranoid personality disorder.
Research shows that personality problems (maladaptive patterns that may or may not warrant a psychiatric diagnosis) are common and often underlie symptoms like anxiety and depression. People with healthy personalities generally benefit from short-term treatments that focus on specific symptoms. People with personality difficulties often do not benefit from symptom-focused treatments. They require treatment that addresses broader personality traits. In other words, they require treatment that addresses who they are in addition to the symptoms they have.
Signs of Personality Health
- Ability to engage in mutually satisfying relationships (for example, love relationships, friendships, work relationships)
- Ability to experience and express a full range of thoughts and feelings
- Ability to function flexibly (using a variety of coping strategies) when stressed by external problems or internal conflict
- Ability to work
- Stable sense of identity (knowing who you are and being true to yourself)
- Ability to adapt to change
- Ability to make constructive use of criticism
- Ability to find pleasure, joy, and meaning in life
Signs of Personality Disturbance
- Responds to stress in rigid or inflexible ways
- Problems with work
- Problems with relationships
- Inability to enjoy life
- Self-destructive behaviors
- Unstable sense of identity (for example, feeling as if you don’t know who you are or the different sides of you don’t fit together)
- Problems with moral functioning (for example, cheating or habitual lying)
- Trouble managing emotions (for example, emotional explosions, rage attacks)
- Restricted range of emotions
- Extreme reactions to other people (for example, “black and white” thinking)
For Patients
Clinic Hours for First-time Appointments
Tuesdays 9:00 a.m. -- 12:00 noon
To Make an Appointment:
303-724-1000
What to Expect
First Appointment:Your first appointment will last 2 to 2½ hours. You will participate in an in-depth interview by a mental health professional (a psychiatry resident or psychology intern). This interview will cover your current life situation, your childhood and upbringing, your family background, your important relationships, your work history, your feelings about yourself and others, and a range of other topics. Unlike other evaluations where the focus may be primarily on your symptoms, this interview will focus on who you are as a person and how you came to be this way. In some cases, the evaluation may extend over two to three appointments. You may be asked to complete written questionnaires as well.
Feedback: When the evaluation is complete, you will receive feedback about your personality style—which personality traits help you and which may be causing problems for you. For example, your doctor may point out self-defeating patterns in your life and offer some ideas about how these patterns developed and what is maintaining them. If psychotherapy is recommended, your doctor will explain how psychotherapy can help you change.
Treatment:Personality-focused psychotherapy builds on your existing healthy personality strengths and helps you to recognize and change personality traits that are causing problems. To accomplish this, you may need to attend regular psychotherapy appointments (typically once or twice per week). In some cases, other treatments may be recommended, such as medication, group therapy, stress reduction training, or substance abuse treatment. Personality-focused psychotherapy relies heavily on the personal relationship that develops between you and your therapist. The problems that you experience in other relationships are likely to arise, in one form or another, in your relationship with your therapist. By discussing and understanding these problems as they arise, you will gain the freedom to have different and better relationships and to cope more effectively with life’s challenges.
Payment: We will check with your health insurance company to determine whether your insurance policy covers psychotherapy at our clinic. Patients without insurance coverage may self-pay.
Physicians and Staff
The Personality Styles and Disorders Specialty Clinic is co-directed by Jonathan Shedler, PhD and Robert Feinstein, MD. Dr. Shedler is an Associate Professor in the Department of Psychiatry and one of the nation’s leading researchers in the field of personality. He has authored numerous articles on personality and personality disorders and lectures to professional audiences nationwide. Dr. Shedler is the developer of the Shedler-Westen Assessment Procedure (SWAP) for personality diagnosis. Dr. Feinstein is a Professor of Psychiatry, Practice Director of the Outpatient Psychiatry Department, and Vice Chairman of Clinical Education and Evidence-Based Medicine in the Department of Psychiatry. He has 25 years of experience treating and writing about personality disorders. Dr. Shedler and Dr. Feinstein provide oversight and clinical direction to the Personality Styles and Personality Disorders Specialty Clinic and to the psychiatry residents and psychology interns who provide clinical care.
How to Get a Referral
Your physician or mental health professional can refer you to the
Personality Styles and Personality Disorders Specialty Clinic by calling 303-724-1005. You should then contact our staff to schedule an evaluation and mention the name of your referring healthcare
professional.
You may also self-refer to the clinic by contacting our staff directly and
requesting an evaluation in the Personality Styles and Personality Disorders
Specialty Clinic.
For Medical Professionals
The Personality Styles and Personality Disorders Specialty Clinic utilizes evidence-based treatments including individual and group psychotherapy. Psychotherapy modalities include Transference Focused Psychotherapy (TFP), Cognitive Behavioral Therapy (CBT), and Dialectical Behavior Therapy (DBT). The clinic is appropriate for all adult patients with maladaptive personality patterns, whether or not the patient meets DSM-IV diagnostic criteria for an axis II diagnosis. The Personality Styles and Personality Disorders Specialty Clinic does not treat patients with psychotic disorders or current substance abuse disorders.
Patient Assessment
The initial evaluation requires a minimum of 2½ hours. The clinician will conduct a systematic, semi-structured clinical interview designed to elicit information relevant to personality functioning. Clinical observations and findings will be recorded using the Shedler-Westen Assessment Procedure (SWAP) for personality diagnosis. The SWAP provides a formal DSM-IV axis II diagnosis where applicable, as well as a clinical case formulation that serves as a roadmap to psychotherapeutic treatment. The evaluation also covers personality “styles” that do not warrant axis II diagnoses but which nevertheless cause ongoing distress and are appropriately addressed through psychotherapy.
Physician Consultations
The Personality Styles and Personality Disorders Specialty Clinic provides consultations to mental health professionals in the community. The consultations are designed to help mental health professionals with challenging cases. Private supervision is available, and lectures by Dr. Shedler and Dr. Feinstein to professional groups can be arranged.
