Assessing personality disorder within a formulation framework
Clinicians working with this population experience challenging clients who may be denigrating, demanding, rejecting and aggressive or, alternatively, passive and detached in style. They are often referred to in highly negative and pejorative terms. Many service providers have previously relied on the exclusion from treatment clause of the Mental Health Act (1983) as a way of legitimising not oﬀering services to this group of people. Conversely, other clinicians avoid diagnosing personality disorder as they feel ill equipped to do so (Duggan and Gibbon, 2008), or fear the label will be used by others to exclude the individual from treatment. With high prevalence rates, the amendments to the Mental Health Act (2007) and new treatment initiatives, it is important that service providers adopt an eﬀective assessment model to identify the presence of the condition and design eﬀective treatment.