Enhancing Training and Education on Treatment Readiness in Personality Disorders: A Case-based Discussion

Patients with a personality disorder are frequently encountered in clinical settings, and their treatment often poses unique clinical dilemmas given specific features of the illness and treatment landscapes that are commonly austere. The past few decades have seen the emergence of new models for conceptualizing personality disorders and several new evidence-based treatments. However, the question of which patient should be matched to which treatment, and when, is a significantly under-investigated topic. We propose that one important component of answering this question is considering readiness for treatment, which has not received the same degree of attention as it has in other areas of mental health treatment. While there are currently no empirically validated tools to reliably quantify readiness for treatment, here we argue that it is still an important topic to consider when working with this patient population. We present 3 different case-based discussions where different features of personality disorders and different features of readiness are highlighted, along with several potential elements that could be included in clinical education curricula. In addition to benefiting patients, a more direct consideration of readiness for treatment may also benefit providers by reducing moral distress and the health care system more broadly by improving resource allocation.