Assessing and Formulating Personality Disorder

This is a Practitioner course in the personality disorder pathway. It assumes that you already hold the Foundation knowledge of this approach, whether from the Foundation course or from your training and practice, which is what Understanding Personality Disorders teaches. What it adds is formulation and treatment decisions with real caseloads: the disorder-specific or situation-specific methods, sequencing, and what to do when the standard approach does not work; it revisits the foundations only as far as it needs to before building on them, so it does not repeat the course below.

If you have not met this approach before, Understanding Personality Disorders is the place to start; if you already hold its foundations from your training or practice, this is the right level to begin at.

The personality disorder pathway. Understanding personality disorder and the dimensional model, assessing and formulating it, then treating it: the evidence, the treatments and the systems around them.

• Conducting a dimensional assessment Structuring the interview
• The assessment as a therapeutic act Engagement and validation in assessment
• Achieving Reliable Dimensional Ratings: Calibration, Inter‑rater Consistency and Structured Instruments Clear rating anchors linked to concrete behavioural exemplars improve consistency across clinicians.
• Integrating Dimensional Ratings into Clinical Formulation and Intervention Planning Dimensional ratings should be woven into a narrative that links trait elevations to developmental history and current maintaining factors.

• Triangulation and the Dynamic Formulation: Synthesizing Multi-Source Data into a Narrative of Change Risk is where services most often abandon their own principles about this population, and where the cost of abandoning them is highest. The reflexes learned fro…
• Longitudinal Monitoring of Dimensional Ratings in Personality Disorder Longitudinal dimensional monitoring captures clinically meaningful change in severity and traits over the course of therapy.
• Beyond the Five-Factor Model: Integrating Alternative Dimensional Frameworks into Personality Disorder Assessment Clinicians should integrate alternative dimensional frameworks—such as the AMPD and PDM-2—alongside the FFM to capture the full spectrum of personality pathology, particularly functional impairment and developmental context.
• Assessing and formulating risk Chronic versus acute-on-chronic risk
• Building a shared formulation Integrating history, traits and cycles

• From Shared Formulation to Collaborative Risk Management Planning Translate the shared formulation into a co‑owned, dynamic risk management plan.
• Integrating Protective Factors and Resilience into Risk Formulation for Personality Disorder Protective factors should be assessed alongside risk indicators to create a balanced formulation.
• Inclusive Risk Formulation: Addressing Power, Stigma and Cultural Context in Personality Disorder Work Risk formulation must integrate the client’s narrative and sociocultural context alongside structured tools.
• Formulating Risk as a Dynamic Process: Monitoring, Re‑formulation and Temporal Nuance in Personality Disorder Risk in personality disorder is fluid and must be conceptualised as interacting trajectories rather than a static point.
• Integrating Dimensional Assessment of Personality Disorder into Risk Formulation Dimensional models (AMPD, ICD‑11) provide continuous ratings of personality functioning and traits that can be directly linked to risk pathways.