For individuals with chronic, complex problems that include multiple Axis I disorders comorbid with personality disorders, the barriers to change are significant. This book presents a powerful therapeutic approach that integrates psychodynamic, cognitive-behavioral, client-centered, and other techniques to empower patients to overcome these barriers by fostering change in personality. Interpersonal Reconstructive Therapy (IRT) is grounded in an innovative case formulation method that systematically links symptoms to maladaptive patterns in attachment relationships. IRT offers a step-by-step framework for structuring interventions to promote learning of new, healthier patterns, while blocking problem behaviors and building a strong therapeutic alliance. A new preface in the paperback edition addresses current developments in IRT research and practice.