A review of the literature shows over 30 randomly controlled treatment studies evaluating the efficacy of treatment for personality disorders but most focused on borderline personality disorder and none specifically on NPD. There are a number of studies, which include NPD in their sample, but sample sizes are so small that specific implications cannot be generalized for NPD. While there is a dearth of empirical evidence demonstrating efficacy for any single approach for NPD, there are a number of treatment approaches, which have been suggested for narcissism and NPD. Currently, there is only one approach specifically for NPD, but no single approach has shown efficacy using randomly controlled treatment studies. However, there is substantial clinical case material and anecdotal evidence suggesting that integrative and unified approaches are the most suited for narcissistic trait and personality disorders.