Assessment and Treatment Planning for Schizotypal Personality Disorder: A Metacognitively Oriented Point of View

Objective: The aim of this study was to pilot test a novel assessment and treatment plan for patients with a schizotypal personality disorder by integrating the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) alternative model of personality disorders, metacognitively oriented psychotherapies. and recovery approaches. Method: I recruited 12 patients diagnosed with schizotypal personality disorder. I report results from the global assessment including measures on symptoms, maladaptive traits. Big Five personality traits, schizophrenia proneness, and metacognition. I also describe how I planned treatment to promote an individualized understanding of a person's agenda and recovery. The treatment plans were also evaluated through in-depth qualitative interviews at the end of the intervention. Interviews were analyzed through a phenomenological framework and a computer-aided qualitative analysis software. Results: Assessment results and qualitative interviews highlight the importance of a multilevel, progressive treatment plan aimed at considering the personality functioning from a recovery-oriented, nonpathologizing approach. On 1 hand, an assessment that focuses on both healthy and maladaptive traits fosters a progressive redefinition of the therapeutic agenda. On the other hand. a constant and recursive evaluation of metacognition and personality traits offers a treatment strategy that supports my core assumption that recovery from schizotypal personality disorder is possible. Conclusions and implications for Practice: A twofold focus on personality traits and metacognition seems to represent a viable strategy for treating patients with schizotypal personality disorder. A metacognitively oriented rehabilitation may be a flexible, personalized and effective approach toward recovery.