This approach effectively addresses APD cognitive distortions regarding their sense of competency and self-worth. As with behaviour therapy, the cognitive approach assists individuals with APD to identify their negative self-thoughts and the origin of these thoughts. They also need to know that others struggle with similar issues and that they are not alone (Will, Retzlaff, ed., 1995, p. 98).
If the self-talk of individuals with APD has become savage in its self-deprecatory intent, little progress in treatment can be achieved if this pattern is not altered. Self-statements must be clearly identified; clients should be asked specifically what they call themselves or how they refer to themselves when feeling inept, inadequate, or unacceptable. The words can be startling in their intensity and viciousness. These must be countered in the treatment process with constructive, realistic, and self-accepting statements of encouragement and affirmations directed toward self-efficacy.
The therapist will not have a personal relationship with the client and will adopt the role of 'teacher' to the clients' 'student'.