This is a structured manual aimed at guiding the action of the clinician in dealing with difficult patients from the first session to the last.

Giancarlo Dimaggio is a co-founding member of the Center for Metacognitive Interpersonal Therapy. He is the author of four books and numerous articles.

Antonella Montano is a founding member and director of the psychotherapy school A.T. Beck Institute for Cognitive Behavior Therapy. He is a teacher and supervisor of the Associazione Italiana Analisi e Modificazione del Comportamento (AIAMC), a certified trainer/consultant/speaker/supervisor of the Academy of Cognitive Therapy (ACT), a member of the International Association for Cognitive Psychotherapy (IACP) and a member of the International Society for Sexual Medicine (ISSM).

Raffaele Popolo is a co-founding member of the Center for Metacognitive Interpersonal Therapy, a trainer at the Società Italiana di Terapia Comportamentale e Cognitiva (SITCC)a trainer of the psychotherapy school 'Studi Cognitivi'.

Giampaolo Salvatore is a co-founding member of the Center for Metacognitive Interpersonal Therapy, a trainer at A.T. Beck Institute for Cognitive Behavior Therapy.

Introduction. Personality Disorder Psychopathology: Form and Contents of Subjective Experience. Personality Disorder Psychopathology: Functions. Assessment and Case Formulation in Metacognitive Interpersonal Therapy. Step-By-Step Formalized Procedures. Therapeutic Relationship. Shared Formulation of Functioning: Enriching Autobiographical Memory, Improving Access to Inner States and Reconstructing Schemas. Promoting Differentiation. Construction of New Self-Aspects: Access to Healthy Parts, Exploration, Increase in Agency, Overcoming Avoidances. Promoting the Understanding of the Other's Mind and Integration. Treating Symptoms and Promoting Mastery of Relational Problems. Comparison of Metacognitive Interpersonal Therapy and Cognitive-Behavioral Therapies. Appendix: Diagnostic Instruments Usually Adopted in MIT.