ABSTRACT
Basically, individuals with avoidant personality disorder are aloof, ill at ease, socially awkward, and overly sensitive to criticism. Although they are desperate for interpersonal involvement, they avoid personal contact with others because of their heightened fear of social disapproval and rejection. While treatment of such individuals involves a number of unique therapeutic challenges, it can be highly effective and successful. This chapter describes a framework for effective treatment of this disorder from a cognitive behavioral perspective. It includes sections on assessment, case conceptualization, and treatment interventions. The section on assessment includes behavioral and cognitive factors, as well as a DSM-5 description and a prototypic description of this disorder. A prototype is a brief description that captures the essence of how a particular disorder commonly presents. Prototypic descriptions are useful and convenient and clinicians commonly rely on them rather than lists of behavioral criteria and core and instrumental beliefs (Westen, 2012). The section on case conceptualization provides both cognitive and behavioral formulations of this disorder. The longest section is on treatment. It emphasizes engagement, pattern analysis, pattern change, and pattern maintenance and termination strategies for effectively managing and treating this disorder. In addition to individual psychotherapeutic strategies and tactics, group, marital and family, medication, and integrative and combined treatment strategies are included. An extensive case example illustrates the treatment process.
