For individuals with AvPD, the goal of treatment is to increase self-esteem, increase confidence in interpersonal relationships, and to de-sensitize their reaction to criticism (Sperry, 1995, p. 44). Treatment should be directed toward reinforcing a self-concept of competency. These individuals can learn to balance caution with action and to develop a tolerance for failure (Dorr, Retzlaff, ed., 1995, pp. 196-197).
One must beware of the clinician that is overprotective of the patient and holds up progress - this sustains the poor view of self that the patient has come to treatment to remedy. The other clinician to beware is the one who forces the patient to face new situations prematurely, without proper preparation, and who then criticizes the patient for not being "brave" enough.
Millon (Millon & Davis, 1996, pp. 281-282) believes that the ultimate aim of therapeutic intervention is to counter the tendency for individuals with AvPD to perpetuate a pattern of social withdrawal, perceptual hypervigilance, and intentional cognitive interference. He does note, however, that these individuals often have a poor prognosis. Their habits and attitudes are pervasive and ingrained, as with all the personality disorder patterns. They are rarely in a supportive environment that could assist them to change their behavior. They are also inclined, in treatment, to reveal only that which will not cause the service provider or other group members to think ill of them.
As with all of the personality disorders, individuals with AvPD cannot become their own personality and temperamental opposite. While they may, in fact, fantasize about becoming an outgoing, confident extrovert, the development of a more functional version of their basic personality traits can lead to a substantial improvement in the subjective experience of the quality of their lives. Oldham (1990, pp. 173-182) suggests that the more functional personality style of the avoidant personality disorder is the "sensitive personality style." These individuals are comfortable with the familiar, stay close to family and a limited number of friends, care what others think about them, are cautious and deliberate in dealing with others, and maintain a courteous, polite interpersonal reserve. Within their own homes and with friends, they are warm, giving, open and creative. The implication is that these individuals can develop rewarding relationships and live with interpersonal connectedness while not pressuring themselves to be excessively outgoing. They do not have to be extroverted to avoid isolation.
Accordingly, it is important that treatment goals address realistic expectations for change, including confrontation of fantasies that cannot be realized and should not be part of the treatment plan.