Cognitive therapy was initially developed as a treatment for depression (A. T. Beck, Rush, Shaw, & Emery, 1979) and has subsequently been applied with a wide range of disorders such as anxiety disorders (A. T. Beck & Emery, 1985), substance abuse (A. T. Beck, Wright, Newman, & Liese, 1993), marital and family problems (Epstein & Baucom, 2002), and even schizophrenia (Perris & McGorry, 1998). However, although the principles of cognitive therapy apply across the full range of psychiatric problems, the treatment approach needs to be modified to take into account the characteristics of the individuals being treated. Some have argued that cognitive therapy of depression (A. T. Beck et al., 1979) is not an appropriate treatment for individuals with personality disorders (McGinn & Young, 1996; Rothstein & Vallis, 1991; Young, 1990) and this is indeed the case. Cognitive therapy of depression is a protocol for treating depression and somewhat different protocols are used in treating other disorders. Cognitive therapy of personality disorders (A. T. Beck et al., 1990; Freeman, Pretzer, Fleming, & Simon, 1990; Pretzer, 1998; Pretzer & Beck, 1996) would be used in treating personality disorders and we would combine the two approaches in treating an individual who manifests both depression and a personality disorder.
There is a consensus among investigators developing cognitive therapy approaches to the treatment of personality disorders that it is important to develop conceptualizations and treatment approaches tailored to specific personality disorders rather than relying on a generic approach that does not distinguish between the various personality disorders. Unfortunately, a discussion of cognitive therapy with each of the personality disorders is beyond the scope of this chapter. This chapter discusses the general principles of cognitive therapy with personality disorders. For approaches to understanding and treating each of the personality disorders, see A. T. Beck et al. (1990) and Freeman et al. (1990).
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