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Borderline, Narcissistic, Antisocial & Histrionic Personality Disorders — Dr. Gregory Lester

Borderline, Narcissistic, Antisocial & Histrionic Personality Disorders:
Effective Treatments for Challenging Clients

Spend a day with Dr. Gregory Lester exploring the diagnostic frameworks and clinical strategies he applies in his own work with Cluster B personality disorders.

— Reserve Now — Choose a format

Join Dr. Gregory Lester as he delivers an intensive workshop and seminar designed to provide you with the knowledge, skills, and abilities to identify and treat your most difficult personality-disordered clients. Better understand your clients with Antisocial, Narcissistic, Histrionic and Borderline Personality Disorder — and make a breakthrough in clinical treatment.

  • Manage the manipulative and possibly violent Antisocial Personality Disorder in session.
  • Overcome the Narcissistic Personality Disorder trait of perfectionism and combat their need to overpower you as the therapist.
  • Better understand your clients diagnosed with Histrionic Personality Disorder, whose intense emotions and need for attention will test your patience and compassion.
  • Help the Borderline Personality Disorder client deal with their explosive emotions, self-harm tendencies and cravings for chaos.
Case studies and video examples will be used to illustrate client symptom presentation, treatment, and management of each cluster B client type. You will explore various modalities that are effective with antisocial, narcissistic, histrionic, and borderline personality disorders — Motivational Interviewing, Cognitive-Behavioral, Interpersonal, and Dialectical therapies. Each of these theories will be explored to provide you with solid and usable skills to include in your daily practice.

If you've ever walked out of a session wondering
what just happened… this is for you.

Let's be honest about what nobody trained us for.

You finish a session with that client — you know the one — and you're not sure if you helped them or got played by them. Again.

You went into this field to help people. You did the schooling, the supervised hours, the licensing exam. You learned the modalities. You can run a textbook CBT session in your sleep.

And then a Borderline client walks in and rips your treatment plan in half before week three.

Or the narcissist who, somehow, has you defending yourself by the second session — in the room you're supposed to be running.

Or the antisocial client your agency keeps assigning you because "you're good with the hard ones" — and you're starting to think "good with the hard ones" means "willing to be exhausted."

Or the histrionic client whose chart says "depression" and "anxiety" and "adjustment disorder" — because three clinicians before you also missed what was actually going on.

Here's the part nobody says out loud:

Most of us got maybe one lecture on personality disorders in grad school. A chapter. A weekend somewhere. Then we got thrown into caseloads where cluster B clients show up far more often than our training prepared us for — and we're running standard interventions designed for everyone except them.

And it's not just frustrating. It's the reason you go home and replay sessions in your head. It's the reason your supervision hour gets eaten up by the same three clients every week.

It's the reason you wonder, sometimes, if you're actually any good at this.

You're not alone in this.
Most clinicians weren't given a thorough framework for personality disorders in graduate training.
That's the gap this training is designed to address.
— The Full Day, Section By Section —

Every topic. Every diagnosis. Every technique.

Understanding personality disorders

  • Updates to DSM-5-TR® and future changes
  • The real purpose of diagnosis
  • Treatment errors and misdiagnosis
  • Core vs. surface structures
  • Four central components to diagnosis
  • Risks and limitations
Part 2: Antisocial character
  • Understanding psychopathology
  • Developmental progress in childhood
  • Oppositional defiance
  • Attachment and family of origin
  • Primary defenses and affects
  • Importance of personal power
  • Managing in-session violence
  • Suicide attempts and threats
  • Blockades — manipulation and power struggles
  • Risk analysis to self and other
  • Interpersonal theory techniques
  • Transference and countertransference
  • Lessen destructive behaviors
  • Cognitive-behavioral techniques
  • Psychopharmacology and applicability
  • Case studies and treatment exercises
  • Differential diagnoses
Part 3: Borderline character
  • Symptom presentation along the spectrum
  • Attachment and family backgrounds
  • Feeling identification and behavioral control
  • Manage rage, boundaries, self-mutilation and suicidality
  • Facilitate pattern recognition, create stability, and build therapeutic collaboration
  • Develop true sense of self and lessen maladaptive need for attention
  • Underlying wishes and fears
  • Build DBT core mindfulness skills
  • DBT techniques to dissolve distraction, calm interpersonal upheavals, and focus on the "genuine relationship"
  • DBT emotion regulation skills
  • Psychopharmacology and applicability
  • Case studies and treatment exercises
  • Differential diagnoses
Part 4: Narcissistic character
  • Narcissism and environmental contexts
  • Attachment and family backgrounds
  • Primary defenses and affects
  • Tackle the veneer of perfectionism
  • Blockades — power struggles, empathy and criticism
  • The narcissistic/borderline client
  • Interpersonal strategies for empathy
  • CBT techniques to clarify behaviors, values and goals
  • Tactics to avoid arguing
  • Motivational interviewing to overcome resistance
  • Prevent sabotage
  • Build a sense of true self
  • Psychopharmacology and applicability
  • Case studies and treatment exercises
  • Differential diagnoses
Part 5: Histrionic character
  • Moody to excited to flamboyant: the erratic client
  • Attachment and family backgrounds
  • Primary defenses and affects
  • Coquettish behavior, avoidance drama, inauthenticity
  • Dangers of the histrionic client
  • Link between emotions and behavior
  • Interpersonal strategies for expression of true self
  • Enhance sense of self and lessen the "spotlight"
  • Motivational interviewing techniques
  • DBT techniques
  • Interpersonal strategies for positive relationships
  • Strengthen self-initiative and independent action
  • Psychopharmacology and applicability
  • Case studies and treatment exercises
  • Differential diagnoses
★★★★★

"Of all the webinar CE courses I have taken, Dr. Lester's was the most interesting and educational I have come across."

— Psychologist
— Meet Your Presenter —

Dr. Gregory W. Lester is a clinical, consulting, and research psychologist with practices in Colorado and Texas. In nearly 40 years of clinical practice, Dr. Lester has treated over 1,000 personality disorder cases and has performed psychological evaluations on over 2,500 individuals.

He has delivered over 2,000 personality disorder trainings to professionals across the United States, Canada, and Australia. He has served on the graduate faculty of The University of St. Thomas and as a special consultant to The United States Department of Justice.

Dr. Lester's office served as one of the research sites contributing to the DSM-5® revision of the personality disorders section, in collaboration with Emory University, the New York State Psychiatric Group, The University of Missouri, The University of Kentucky, and the late Dr. Robert Spitzer, chairman of the DSM-3 committee.

He is the author of nine books, including Power with People, a manual of interpersonal effectiveness, Shrunken Heads, a memoir of his graduate school training, and Diagnosis, Treatment, and Management of Personality Disorders — a widely-used clinical manual on diagnosing, treating, and managing personality disorders.

His research has appeared in publications including The Journal of the American Medical Association, The Western Journal of Medicine, The Yearbook of Family Practice, The Journal of Behavioral Therapy, The Journal of Marriage and Family Therapy, and The Handbook of Depression.

Click here for information about Gregory Lester

DSM
DSM-5® Personality Disorders Research Site
Dr. Lester's office was one of the original research sites for the DSM-5® personality disorders revision.
2,000+
Trainings Delivered
200K+
Clinicians Trained
1,000+
PD Cases Treated
2,500+
Psych Evals Performed
9
Books Published
40 yrs
Specializing in PDs
— A Note From the Presenter —

I know how busy you are. Ever since the pandemic, mental health demand has gone through the roof. I practice in Texas and Colorado and I don't have a single colleague with an opening. My guess is your world looks pretty similar.

So here's my flat-out promise: this day will be well worth your while.

Personality disorders are my thing. Have been since 1984. They're my interest, sort of my passion — what I have a knack for and what I'm good at, quite frankly. I've spent decades training human services professionals on this topic — hundreds of cities, tens of thousands of clinicians. I share that so you know what you're about to learn isn't one person's pet theory. It's been refined through a lot of rooms.

Here's why you're considering this seminar: you already know the secret nobody likes to say out loud. Traditional models often need to be substantially adapted for these clients. Medication doesn't touch the personality itself. Cognitive therapy on its own has historically run into limits here — Aaron Beck himself wrote about that in 1990. Most of the approaches you learned in grad school benefit from significant adaptation before they consistently move the needle. And nobody trained you in the adaptations.

That's part of why difficult clients feel so difficult. The tools many of us were handed weren't built specifically for this problem.

In one day, I'm going to show you what a personality disorder actually is — not the textbook checklist, but the underlying structure. Once you see it, my hope is you'll have an "oh, that's why the standard stuff doesn't always work" moment.

Then we'll get practical. We'll talk about how I think through, in one intake, whether the client in front of me is someone I'd lean toward treating versus managing. We'll talk about the published research on retention with this population. We'll talk about the drama hooks each cluster B can throw and how I try to side-step them without going cold or punitive. And we'll talk about the role of the observing ego in clinical work — a topic many clinicians tell me they received limited training in.

Here's what I hope you'll take away: a clearer conceptualization of what you're looking at, a framework for the management-versus-treatment question, and some specific clinical language you can adapt to your own practice.

Come spend the day with me. I'll see you in there.

— Greg
Gregory W. Lester, Ph.D.

What 200,000+ clinicians have said about Dr. Lester's trainings.

★★★★★

"Of all the webinar CE courses I have taken, Dr. Lester's was the most interesting and educational I have come across."

— Psychologist
★★★★★

"This is the best program that I have ever attended."

— Psychologist, Community/Mental Health
★★★★★

"Excellent presentation. One of the best ever."

— Social Worker, K-12
★★★★★

"Whole conceptualization has changed."

— Psychologist
★★★★★

"One of the most helpful and concise conferences I have attended — and I am a very old man."

— Psychologist
★★★★★

"Wonderful — challenged my traditional thinking of how personality disorders are linked to trauma related disorders."

— Counselor/Psychotherapist
★★★★★

"I received so many useful tools in this seminar. I would definitely take a course with him again."

— Social Worker, Child/Adolescent
★★★★★

"I learned a new way to think about personality disorders — and more effective ways to treat them."

— Social Worker, Community Mental Health
★★★★★

"Amazing speaker! I have already purchased additional trainings of his."

— Counselor/Psychotherapist
★★★★★

"Would highly recommend this course to others. Very useful, easily digestible — but so much depth to the content."

— Social Worker (General)
★★★★★

"Truly excellent speaker. Informative and engaging."

— Social Worker (General)
★★★★★

"I can now recognize how one of my clients in the past has manipulated me tremendously."

— Social Worker (General)

Build your clinical toolkit for working with Cluster B clients.

1

Determine how the changes with the DSM-5-TR® impacts diagnosis and treatment of the Cluster B Personality Disorders.

2

Differentiate symptom overlap, effective treatment and emotional management of each Cluster B Personality Disorders client type.

3

Choose strategies to manage the manipulative and potentially violent behaviors with your clients diagnosed with Antisocial Personality Disorder in session to make therapeutic progress.

4

Utilize CBT techniques to clarify behaviors, values and goals with clients diagnosed with Narcissistic Personality Disorder.

5

Apply techniques to decrease explosive emotions, self-harm tendencies and cravings for chaos for clients diagnosed with Borderline Personality Disorder.

6

Utilize MI and DBT techniques with clients diagnosed with Histrionic Personality Disorder to help manage cognition and improve emotional regulation.

What clinicians have said this program prepared them to work on.

Approach intake with greater awareness of Cluster B presentations — including how personality disorders may be obscured by surface diagnoses.

Think through differential considerations when a presentation could involve trauma, mood, substance use, or personality factors.

Apply clinical strategies discussed in the workshop when working with Antisocial presentations, including manipulation, intimidation, and power dynamics in session.

Use DBT mindfulness and emotion regulation techniques with Borderline clients toward goals of reduced self-harm and improved emotional regulation.

Consider a treatment frame with clearer agreements and consequences as a structural element of clinical work.

Recognize patterns that may inadvertently reinforce target behaviors, and consider alternative session structures.

Bring the workshop's vocabulary and framework into supervision when working with clinicians on Cluster B caseloads.

Discuss approaches to safety considerations for in-session crises, including suicidality and self-harm threats.

Refine your conceptualization of personality disorders with current diagnostic considerations and clinical strategies.

— Built For Real Caseloads —

This training was built for the clinician with a real caseload,
not the textbook one.

This is for you if you're a…

  • Counselor or psychotherapist — generalist, addictions, K-12 school, child/adolescent, or community mental health
  • Social worker — community mental health, child/adolescent, school, or generalist
  • Psychologist — generalist, child/adolescent, CMH, school, or addictions/offenders
  • Marriage and family therapist
  • Psychiatrist or nurse practitioner managing the medication side of Cluster B
  • Case manager, rehabilitation professional, or clinical supervisor running point on the hardest caseloads
  • Supervisor of clinicians getting chewed up by Cluster B clients — and you need a framework to teach

You'll use this in…

  • Private practice — individual sessions and treatment planning
  • Community mental health clinics and agency caseloads
  • Inpatient and residential settings
  • Confined / secure / forensic settings
  • Crisis work and threat assessment
  • Emergency department social work
  • Substance use disorder treatment programs
  • Group therapy & school-based mental health (K-12)
  • Supervision, clinical training, and primary care behavioral health consultation
— Group Registration —

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FAQs

"Who was this training designed for?"+
This training is designed for mental health and human services professionals who work with clients who may present with Cluster B personality disorders, including:
  • Counselors
  • Social Workers
  • Psychologists
  • Psychotherapists
  • Therapists
  • Addiction Counselors
  • Marriage and Family Therapists
  • Case Managers
  • Nurses
  • Physicians
  • Other Mental Health Professionals
"Where are the in-person trainings held?"+
Fort Collins, CO
February 4, 2027
Fort Collins Marriott
350 East Horsetooth Rd
Fort Collins, CO
Denver, CO
February 5, 2027
Courtyard by Marriott Denver / Cherry Creek
1475 S. Colorado Blvd
Denver, CO
Day-of Schedule Mountain Time
  • 7:30 AMRegistration & check-in
  • 8:00 AMTraining begins
  • — mid-morning15-minute break
  • 11:50 AM – 1:00 PMLunch (on your own)
  • — mid-afternoon15-minute break
  • 4:00 PMTraining ends

Please note: You will have access for 90 days after the program for review. For live CE credit, you must watch the live presentation in its entirety at its scheduled time and complete the CE quiz and evaluation within one week. Please note that this requirement may vary by credit type. Please see detailed credit information for specific requirements for each credit type.

Roughly one in four clients with personality disorders leave treatment prematurely — significantly more often than clients with mood or anxiety disorders — and most who leave do so early in the work. (Iliakis et al., 2021)

The clinical strategies Dr. Lester teaches were built for that reality.

★ Narcissistic Presentations

Reframing common assumptions about narcissism.

Clinical conceptualizations of narcissism extend beyond colloquial uses of the term, with attention to image-based defenses, engagement strategies, and considerations for working with criticism sensitivity.

★ Antisocial Presentations

In-session dynamics and safety considerations.

Common interpersonal patterns clinicians may encounter — including ingratiation, intimidation, and boundary testing — alongside safety considerations and clinical strategies for maintaining a working frame.

★ Borderline Presentations

DBT applications and clinical context.

How DBT mindfulness and emotion regulation techniques may apply with Borderline clients, including considerations for longer-term treatment planning and outcomes documented in the research literature.

★ Histrionic Presentations

Distinguishing histrionic from borderline affect.

Clinical considerations for differentiating between histrionic and borderline affective presentations — both of which involve emotional intensity and shifts — and how that distinction may inform treatment planning.

★ Therapeutic Connection

The role of connection and observation in clinical work with personality disorders.

How verbal interventions and the therapeutic relationship may relate to longer-term clinical work with personality-disordered clients, with reference to relevant research literature where applicable.

— Reserve Your Seat —

Spend a day on the clinical material
most of us never got in training.

A working day with Dr. Gregory Lester on the frameworks, considerations,
and clinical strategies he applies in his own work with Cluster B personality disorders.

BORDERLINE · NARCISSISTIC · ANTISOCIAL · HISTRIONIC PERSONALITY DISORDERS  ·  EFFECTIVE TREATMENTS FOR CHALLENGING CLIENTS  ·  DR. GREGORY W. LESTER, PH.D.

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We're that confident you'll find this learning experience to be all that's promised and more than you expected.