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Schema Theory and Introduction

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Schema Theory and Introduction Wendy T. Behary, Director The NJ Institute for Schema Therapy Past President, The International Society of Schema Therapy, ISST (2010-2014) – PowerPoint PPT presentation

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Title: Schema Theory and Introduction


1
Schema Theory and Introduction
  • Wendy T. Behary, DirectorThe NJ Institute for
    Schema Therapy
  • Past President,
  • The International Society of Schema Therapy, ISST
    (2010-2014)
  • Elizabeth Lacy, LCSW
  • Advanced Certified Schema Therapy Trainer and
    Supervisor

2
Schema Therapy Defined
  • An integrative, unifying theory treatment
  • Designed to treat a variety of long-standing
    emotional difficulties, in individuals couples
  • With significant origins in childhood
    adolescent development
  • Combines elements of cognitive-behavioral,
    emotion-focused, attachment psychodynamic models

3
Schema Therapy for Axis IICompared with
Cognitive Therapy for Axis I Disorders
  • Greater emphasis on the therapeutic relationship
  • More emphasis on affect (e.g., imagery,
    role-playing) and mood states
  • More discussion of childhood origins and
    developmental processes
  • More emphasis on lifelong coping styles (e.g.,
    avoidance and overcompensation)
  • More emphasis on entrenched core themes (i.e.,
    schemas)

4
Core Emotional Needs
  • Safety
  • Stable Base, Predictability
  • Love, Nurturing Attention
  • Acceptance Praise
  • Empathy
  • Autonomy
  • Realistic Limits
  • Validation of Feelings Needs

5
Broad Goal of Schema Therapy
  • To help patients get their core needs met
  • In an adaptive manner
  • Through changing maladaptive schemas, coping
    styles modes

6
Schemas Developmental Needs
  • Early Maladaptive Schemas develop when specific,
    core childhood needs are not met

7
Definition Of an Early Maladaptive Schema
  • A broad, pervasive theme or pattern
  • Comprised of memories, emotions cognitions
  • Regarding oneself and one's relationships with
    others
  • Developed during childhood or adolescence, and
    elaborated throughout one's lifetime
  • Dysfunctional to a significant degree

8
Eighteen Early Maladaptive Schemas
  • Failure
  • Subjugation
  • Self-Sacrifice
  • Unrelenting Standards
  • Negativity
  • Entitlement
  • Insufficient Self-Control
  • Emotional Inhibition
  • Punitiveness
  • Abandonment
  • Mistrust Abuse
  • Emotional Deprivation
  • Dependence
  • Vulnerability
  • Enmeshment
  • Defectiveness
  • Social Isolation
  • Approval-Seeking

9
Origins of Schemas
  • Negative childhood adolescent experiences
  • Innate temperament
  • Cultural influences (ethnicity, SES, religion,
    etc.)

10
Maladaptive Coping Styles
  • The ways in which we
  • adapt to distressing environments
  • Surrender responses (giving in)
  • Avoidance responses (running away)
  • Overcompensating responses (fighting back in
    dysfunctional ways)

11
Common Coping Responses
  • Overcompensation
  • Aggression, Hostility
  • Excessive Self-Reliance
  • Manipulation
  • Demandingness
  • Perfectionism
  • Overcontrol
  • Surrender
  • Compliance
  • Avoidance
  • Substance abuse
  • Detachment
  • Social isolation, Avoidance
  • Stimulation, Workaholism

12
Schema Therapy The Mode Approach
13
Rationale Advantages to the Mode Approach
  • History of schema mode concept
  • Developed for more severe clients (BPD, NPD,
    APD)
  • Places more focus on here-and-now mood states
  • Provides more effective strategies to overcome
    avoidance and overcompensation

14
The Schema Mode Concept
  • The specific emotions, cognitions behaviors
    that are currently activated
  • A mode is the predominant state that were in
    at a given point in time (including our
    neurobiological state)
  • Modes include whatever schemas, coping
    responses healthy reactions are activated

15
More About Modes
  • Modes are parts of the self that have not been
    fully integrated (spectrum of dissociation)
  • Maladaptive schema modes develop when core needs
    are not met in childhood adolescence
  • We flip into maladaptive modes when core needs
    are not met and our schemas are triggered

16
Schema Mode Listing
17
Four Types of Schema Modes
  • Innate Child Modes
  • Maladaptive Coping Modes
  • Internalized Caregiver Modes
  • Healthy Adult Mode

18
Assessing Modes
  • Observe each mode in the session through
    discussion of events outside the session
  • Administer interpret the SMI
  • Explain modes to client, with examples. Get
    feedback and tailor names of modes (e..g, Little
    John, The Wall, The Bully, The Soldier, The
    Guard).
  • Teach client to monitor modes by recognizing the
    signs for each mode

19
Schema Modes in BPD
  • Abandoned Abused Child
  • Detached Protector
  • Angry Impulsive Child
  • Punitive Parent
  • Healthy Adult

20
Outcome Research
21
Outpatient Psychotherapyfor Borderline
Personality Disorder Randomized Trial of
Schema-Focused Therapy vs. Transference-Focused
Psychotherapy
Josephine Giesen-Bloo, Arnoud Arntz, et
al. Maastricht University, The Netherlands Archive
s of General Psychiatry June, 2006
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