MCPP Monthly Meeting


Michigan Council for Psychoanalysis and Psychotherapy



“So crazy and dramatic!”:

Therapeutic Assessment with an Adolescent with a Developing Personality Disorder


by Larry Friedberg, Ph.D.


The Michigan League, Henderson Room, Ann Arbor, MI

11 a.m.-1 p.m.

May 19, 2019

No registration needed


A 15-year-old boy was referred by his therapist for a collaborative/therapeutic assessment. She questioned whether there can be any trust or alliance with him; she was feeling very frustrated. She believed this was a client in the process of developing a personality disorder. His parents wanted to know why he lies, steals, manipulates, defies, deliberately annoys, and is generally angry, resentful and dysregulated with them. In the past there were substantial anxiety and panic attacks, now controlled by medication.

One of the main goals of a collaborative assessment is to encourage a patient to develop curiosity about him/herself, to self-reflect, and to help the patient to feel mentalized. These features of C/TA have documented implications for the success of future treatment. In this case, the patient refused to ask any questions about himself, and periodically dismissed and disparaged the assessment, assessor, and therapist. 

In spite of this, a key impact of the assessment for the patient was a gain in trust and curiosity about himself, and a feeling of being understood and accepted. This allowed outpatient therapy to proceed. Implications for assessment in general and for work with adolescents developing a personality disorder will be discussed.


Larry Friedberg, Ph.D. is a psychologist in private practice in Bingham Farms. Dr. Friedberg evaluates and treats children, adolescents, and adults. In addition to his practice as a psychodynamic psychotherapist, Larry specializes in psychological assessment, including forensic evaluations.

For the past nine years, Larry has been actively been engaged in providing collaborative/ therapeutic assessments (C/TA). Therapeutic assessment is a form of psychological evaluation in which the assessment is itself a therapeutic intervention, promoting change in the life of a patient, couple, or family. Steven Finn presented on therapeutic assessment in Michigan in 2009, and Larry has since then continued his training in therapeutic assessment from Steven Finn and the Center for Therapeutic Assessment in Austin, Texas.

Dr. Friedberg received his Ph.D. in Clinical and Developmental Psychology from the University of Michigan in 1984. Larry was the 1999 Distinguished Psychologist named by Michigan Psychological Association, the 2001 MPA President, and the 2007 recipient of MPA’s Beth Clark Service Award.

Larry was an Adjunct Professor at Madonna University, where he taught Assessment, Clinical Theory, and Child and Adolescent Psychopathology. He supervised many students and graduates of Madonna, and more recently has been supervising at the University of Detroit Mercy.

Dr. Friedberg has presented on therapeutic assessment to the Society for Personality Assessment and to psychologists at the Center for Forensic Psychiatry. He has presented numerous times regarding High Conflict Divorce, and did a workshop in 2011 for MPA entitled “The “Court-Involved Therapist: Ethical Dilemmas and Pitfalls.” He and Pamela Ludolph Ph.D. will be presenting for MPA in the fall regarding issues and risks for therapists whose patients are in the midst of family law litigation.


Learning Objectives

Upon completion of this program attendees will be able to:

1) Describe, understand and apply the concepts of mentalization, insecure, dismissive and disorganized attachment to the assessment and treatment of personality psychopathology in adolescence.

2) Understand, interpret, and apply the lessons from collaborative/therapeutic assessment (C/TA) regarding self-mentalization and epistemic trust to psychodynamic assessment and treatment.

3) Understand and apply the implications of epistemic hypervigilance and trust to hard-to-reach patients with significant personality psychopathology.


Relevant Articles

  1. Fonagy, P., Bateman, A., and Luyten, P. (2012) Introduction and Overview. In Bateman, A., & Fonagy, P. Handbook of Mentalizing in Mental Health Practice. Arlington, VA: American Psychiatric Publishing,
  2. Fonagy, P., Luyten, P., Allison, E. and Campbell, C. (2017) What we have changed our minds about: Part 1. Borderline personality disorder as a limitation of resilience. Borderline Personality and Emotional Dysregulation, 4,
  3. Fonagy, P., Luyten, P., Allison, E. and Campbell, C. (2017) What we have changed our minds about: Part 2. Borderline personality disorder, epistemic trust and the developmental significance of social communication. Borderline Personality and Emotional Dysregulation, 4,
  4. Kamphuis, J. & Finn, S. (2018): Therapeutic Assessment in Personality Disorders: Toward the Restoration of Epistemic Trust. Journal of Personality Assessment, 10, 1-13.
  5. Clarkin, J., Fonagy, P., Levy, K., & Bateman, A. Borderline Personality Disorder. (2015) In Luyten, P., Mayes, L., Fonagy, P., Target, M. & Blatt, S. (Eds.) Handbook of Psychodynamic Approaches to Psychopathology. New York: Guilford.
  6. Finn, S., Fischer, C., & Handler, L. (2012) Collaborative/Therapeutic Assessment: Basic Concepts, History, and Research. In In Finn, S., Fischer, C., & Handler, L. (Eds.) Collaborative/Therapeutic Assessment: A casebook and guide. Hoboken, NJ: Wiley.
  7. Fonagy, P., & Luyten, P. (2009) A developmental, mentalization-based approach to the understanding and treatment of borderline personality disorder. Development and Psychopathology, 21, 1355-1381.


 Questions?  Please email David Freiband, Ph.D., V.P. for Programs, at



Michigan Council for Psychoanalysis and Psychotherapy (MCPP) is an independent, contemporary training institute founded on feminist principles and open to diverse theoretical perspectives.  We offer a positive professional community and welcome colleagues from within and without the psychoanalytic community to join us for our free monthly programs and classes. Monthly programs include continental breakfast.

This presentation is open to all interested persons, regardless of their level of experience or knowledge of psychoanalysis. There is no registration needed for our Sunday presentations.

Two social work CEUs and psychology CE credits are available. There is a $10 fee for non-members.*  

The Michigan Council for Psychoanalysis and Psychotherapy is approved by the Michigan Social Work Continuing Education Collaborative to provide CE credits for social workers. The Michigan Council for Psychoanalysis and Psychotherapy maintains responsibility for this program and its content.  

The Michigan Council for Psychoanalysis and Psychotherapy is approved by the American Psychological Association to sponsor continuing education credits for psychologists. The Michigan Council for Psychoanalysis and Psychotherapy maintains responsibility for this program and its content. Click here for the APA certificate. 

For more information please contact V.P. for Programs, David Freiband, at Regarding CEUs for social workers, please contact Marybeth Atwell, LMSW at and CEs for psychologists, please contact Ralph Hutchison, PhD at

* None of the planners and presenters of this continuing education program have any relevant financial relationship to disclose.