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The present case study presents and discusses the challenges represented by a complex case of psychotherapy, focusing on ongoing modifications of the clinical hypotheses and therapeutic approach. This process is illustrated through the case of Andy, a 44\u2010year\u2010old man suffering from depressive disorder, social phobia, substance dependency, and an avoidant personality disorder. This case draws attention to the quality of the relationship and the flexibility and adaptation required from the therapist while depicting an integrative way of working therapeutically with complex cases.<\/jats:p>","DOI":"10.1002\/jclp.22764","type":"journal-article","created":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T16:30:39Z","timestamp":1550593839000},"page":"886-897","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Treating comorbid depression and avoidant personality disorder: The case of Andy"],"prefix":"10.1002","volume":"75","author":[{"given":"Pauline","family":"Maillard","sequence":"first","affiliation":[{"name":"Department of Psychiatry Institute of Psychotherapy, Lausanne University Hospital, University of Lausanne Lausanne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Pellaton","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Institute of Psychotherapy, Lausanne University Hospital, University of Lausanne Lausanne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ueli","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Institute of Psychotherapy, Lausanne University Hospital, University of Lausanne Lausanne Switzerland"},{"name":"Department of Psychiatry General Psychiatry Service, Lausanne University Hospital, University of Lausanne Lausanne Switzerland"},{"name":"Department of Clinical Psychology University of Windsor Windsor Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,19]]},"reference":[{"key":"e_1_2_4_1_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_4_1_3_1","volume-title":"Cognitive Therapy and emotional disorders","author":"Beck A. 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