Dr. Nicole Siegfried is a nationally recognized clinical psychologist, author and expert in evidence-based behavioral health treatment. As Chief Clinical Officer at Lightfully Behavioral Health, she specializes in developing compassionate, whole-person-centered approaches for complex mental health conditions, including personality disorders, mood disorders, anxiety and trauma-related challenges. Dr. Siegfried is passionate about helping people better understand mental health symptoms while connecting them to practical, research-supported care.

Antisocial personality disorder, often called ASPD, is a mental health condition that affects how a person thinks about other people, rules and consequences. Someone with ASPD may repeatedly ignore other people’s rights, safety or boundaries. When someone is looking for treatment for antisocial personality disorder, it is important to understand that care often focuses on safety, healthier choices and other mental health needs. 

ASPD is not the same as having conflict with others, making mistakes or struggling with anger once in a while. It can only be diagnosed in people aged 18 or older. The pattern of antisocial behavior must have been present since at least age 15, with evidence of conduct disorder beginning before age 15. Antisocial personality disorder involves a pattern of disregarding consequences and other people’s rights with estimates of lifetime prevalence range from 2% to 5%.

To better understand treatment options, Dr. Nicole Siegfried, Chief Clinical Officer at Lightfully Behavioral Health, answers common questions about ASPD treatment and what realistic support may involve.

What does antisocial personality disorder treatment usually focus on?

Dr. Siegfried — Treatment for antisocial personality disorder often focuses on helping people make safer choices, take responsibility for their actions and improve everyday life. Treatment may also help with other mental health concerns that happen at the same time, such as anxiety, depression, trauma-related symptoms or substance use.

Treatment is not about changing who someone is overnight. Instead, it helps people build healthier habits and learn practical skills over time.

Treatment may focus on:

• Emotional awareness — Noticing anger, boredom, frustration or fear before reacting
• Safer choices — Creating space between an urge and an action
• Taking responsibility — Understanding how choices affect other people
• Relationship skills — Practicing safer communication and boundaries
• Other symptoms — Treating anxiety, depression, trauma symptoms or substance use when present

Is therapy used to treat antisocial personality disorder?

Dr. Siegfried — Therapy is often an important part of treatment. Sessions usually have clear goals and focus on practical skills people can use in everyday life.

Some people with ASPD may not seek help on their own. Others may enter treatment because of relationship problems, legal concerns, work problems, substance use or pressure from loved ones.

Psychotherapy means talk therapy with a trained mental health clinician. It may help someone:

• Notice risky patterns
• Practice problem-solving
• Build healthier coping skills
• Understand consequences
• Work on relationship conflict
• Address other mental health symptoms

Cognitive behavioral therapy, or CBT, may help a person notice unhelpful thought patterns and practice different responses. Some treatment plans may also include skills from dialectical behavior therapy, or DBT. DBT skills may help when impulsivity, anger or relationship conflict are part of the concern.

Are medications used for ASPD?

Dr. Siegfried — There is no single medication that treats antisocial personality disorder itself. Medication may be considered when a person has specific symptoms or another mental health condition at the same time.

For example, a prescriber may look at whether medication could help with:

• Depression symptoms
• Anxiety symptoms
• Severe irritability
• Impulsivity
• Sleep problems
• Substance use concerns
• Mood instability

Medication decisions should be made by a licensed prescriber after an evaluation. Medication alone is usually not enough. For many people, medication works best when it is combined with therapy, structure and skills practice.

Why is a full evaluation important?

Dr. Siegfried — A full evaluation helps clinicians understand the full picture of a client’s history and current functioning. ASPD symptoms can overlap with other concerns, including substance use, trauma-related symptoms, bipolar disorder, borderline personality disorder or narcissistic personality disorder.

During an evaluation, a clinician may ask about:

• Current symptoms
• Safety concerns
• Relationship patterns
• Impulsive behavior
• Anger or aggression
• Substance use
• Trauma history
• Work or legal concerns
• Mood or anxiety symptoms

This helps make sure treatment fits the person, not just the diagnosis. The plan should be based on symptoms, goals, risks, strengths and support needs.

What role can structure and taking responsibility play in treatment?

Dr. Siegfried — Structure can be very important. People with antisocial personality patterns may struggle with impulsive choices, conflict or following through on responsibilities. A treatment plan may include clear expectations, steady boundaries and practical goals.

Taking responsibility does not mean blaming or shaming someone. In treatment, it means helping someone notice patterns, understand consequences and practice different choices.

Support may include:

• Behavior tracking
• Goal-setting
• Safety planning
• Communication practice
• Plans for risky patterns
• Family or support involvement when appropriate

When might a higher level of care help?

Dr. Siegfried — A higher level of care may help when symptoms are affecting safety, relationships, work or everyday life. It may also help when weekly therapy does not provide enough support.

More support may be needed if someone is experiencing:

• Frequent intense conflict
• Aggressive or risky behavior
• Substance use concerns
• Severe mood or anxiety symptoms
• Trouble keeping up with work, school or relationships
• Self-harm, suicidal thoughts or safety concerns

If someone may harm themselves or someone else, call 911, call or text 988 for the Suicide & Crisis Lifeline or go to the nearest emergency room.

Build healthier patterns with support from Lightfully

At Lightfully, we understand that personality disorder symptoms can affect thoughts, emotions, behaviors, relationships and daily routines. A person may also be dealing with anxiety, depression, trauma-related symptoms, substance use concerns or other mental health challenges.

Through our Precision Care Model, we look at the whole person. That means understanding your thoughts, emotions, behaviors and relationships so we can build a treatment plan that fits your needs. 

Depending on symptoms, safety needs and everyday life, care may include Residential Treatment, Partial Hospitalization Program, Intensive Outpatient Program or Virtual Services. 

If you or someone you love is looking for treatment for antisocial personality disorder or related mental health symptoms, reaching out may help clarify what level of care fits best. 

Change is possible. When you’re ready to take the first step, reach out to our Admissions Concierge Team. We’ll take the next steps together, toward the fullest, brightest version of you.

Frequently asked questions

Can antisocial personality disorder be treated?

Treatment for antisocial personality disorder can be challenging, but support may help reduce harmful patterns, improve responsibility and address other mental health concerns. Care is usually most helpful when it is structured, steady and focused on practical behavior change.

Is antisocial personality disorder the same as being selfish or difficult?

No. Antisocial personality disorder is a diagnosable mental health condition. It involves long-term patterns that affect relationships, safety, responsibility and respect for other people’s rights. Everyday selfishness or conflict does not automatically mean someone has ASPD.

What is the first step in treatment for antisocial personality disorder?

The first step is usually a full evaluation. A licensed clinician can look at symptoms, safety concerns, other mental health conditions, substance use, relationship patterns and treatment goals.

Can loved ones be involved in ASPD treatment?

Sometimes. Family or support involvement may help with boundaries, communication and safety planning. Involvement depends on the person’s consent, clinical needs and whether participation is safe and appropriate.

Does ASPD treatment only focus on behavior?

Behavior is often a major focus, but treatment may also address thoughts, emotions, relationships, trauma-related symptoms, substance use, mood concerns and everyday life. A whole-person plan looks beyond one symptom or label.

What does narcissistic personality disorder treatment usually focus on?

Treatment often focuses on reducing narcissistic personality disorder symptoms, building practical coping skills and understanding the patterns underneath your distress. At Lightfully, your treatment plan is personalized through our Precision Care Model so care can meet your unique needs.

What level of care might help with borderline personality disorder?

The right level of care depends on your symptoms, safety needs and how much support you need right now. Lightfully offers multiple levels of care for adults, including Residential Treatment, Partial Hospitalization Program, Intensive Outpatient Program and Virtual Services.

How does Lightfully personalize its Partial Hospitalization Program to me?

Lightfully uses our Precision Care Model to build a plan around the core processes driving your symptoms. Care may include evidence-based approaches that support thoughts, emotions, behaviors and relationships.

Who is Lightfully’s Intensive Outpatient Program for?

Our Intensive Outpatient Program is for adults who need more support than weekly therapy while continuing daily life at home. Our Admissions Concierge and clinical teams can help determine whether this level of care fits your current needs.

How does Lightfully personalize their Residential Treatment Program to me?

Lightfully uses our Precision Care Model to build a plan around the core processes driving your symptoms. Care may include evidence-based approaches that support thoughts, emotions, behaviors and relationships.