Personality disorders — particularly borderline personality disorder — co-occur with substance use at rates several times the general population. They're also one of the populations many addiction programs refuse to treat, label "non-compliant," or discharge prematurely. RECO Intensive takes them, treats them properly, and has the clinical depth to do it.
What we treat under the personality-disorder umbrella
- Borderline Personality Disorder (BPD) — the most prevalent co-occurring presentation
- Narcissistic Personality Disorder — when clinically present
- Avoidant and Dependent Personality Disorders
- Obsessive-Compulsive Personality Disorder (OCPD) — distinct from OCD
- Antisocial Personality Disorder — carefully assessed and treated when clinical engagement is real
- Personality features below diagnostic threshold — often the more common picture
How RECO treats personality disorders + addiction
DBT as primary modality
Dialectical Behavior Therapy is the gold-standard treatment for BPD. The four DBT modules — mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness — directly address the core deficits that drive both the personality picture and the substance use.
Mentalization and reflective work
Individual therapy with clinicians trained in mentalization-based treatment and other personality-disorder-specialized approaches. Many of the clinical patterns get worked through in the therapeutic relationship itself.
Crisis planning and safety
For clients with chronic suicidality, self-harm history, or impulsive crisis patterns, the treatment plan includes explicit crisis protocols — coordinated with case management, the residence team, and aftercare planning. Safety is engineered, not assumed.
Medication where indicated
Personality disorders aren't directly treated with medication, but co-occurring depression, anxiety, and mood instability often are. Our psychiatric provider manages medications carefully, with awareness of both the substance-use risks and the impulsivity considerations specific to this population.
Who this track serves
Clients with prior BPD diagnoses whose addiction has been called a barrier to treatment. Clients with chronic interpersonal instability and substance use. Clients who've been discharged from prior programs as "too high acuity." Anyone whose recovery requires intensive emotion-regulation work alongside the substance-use treatment.
Why RECO's approach is different
Most addiction programs decline personality-disorder clients or treat them perfunctorily and then discharge them at the first crisis. We staff and structure to do this work — and our DBT infrastructure, individual-therapy depth, and clinical team's willingness to stay engaged through hard moments is what makes the difference. Clients leave with skills that hold.