Complex Problems
Week 2 - Schema Therapy
Lecture 2: Theory and Background
Development of Schema Therapy (ST)
1990s: Jeffrey Young (& colleagues)
Complex problems
CBT +
Consists of:
1. cognitive techniques
2. behavior therapy
3. experiential techniques
Cont.
Psychological Interventions for Complex Problems 1
, more attention for youth trauma (development of schemas/ beliefs)
use of models (“way of being”)
therapeutic relationship as intervention (basic needs)
What is Schema Focused Therapy (SFT)
Integrative psychotherapy combining theory + techniques from:
attachment theory
cognitive
behavioral
gestalt therapy - type of psychotherapy that is centered on increasing person’s awareness,
freedom, and self-direction
transactional analysis
psychodynamic
psychotherapy
psychodrama
Focuses on:
→Early Maladaptive Schema (EMA): Broad, pervasive pattern of memories, emotions,
cognitions and physical sensations, developed during childhood
→Coping Styles: a person’s behavioral response to schemas.
→Mode (mood/temper): mind states that cluster schemas and coping styles into a temporary
“way of being” eg: “vulnerable child mode”
Goals:
→recognize schemas and break through these patterns of thinking, feeling, and behaving
→strengthen the healthy adult mode and happy child mode.
For whom is STF?
ppl with a personality disorder diagnosis - DSM-5
Psychological Interventions for Complex Problems 2
, Longer existing, recurrent symptoms/clinical syndromes that were unsuccessfully treated
before
clinical syndrome is treated first or does not interfere
Patients must have:
some insight into the emergence of negative behavioral patterns / problems
sufficient insight into one’s own emotions and ability to mentalize
Start of therapy
schema therapy in practice - parents/upbringing/environment
5 basic needs
1. safety & connection
2. expression of emotions
3. autonomy
4. realistic limits
5. spontaneity and play
Schema therapy in practice
18 schemas divided over 5 schema domains related to unmet needs
1. disconnection / rejection
2. impaired autonomy and/ or performance
3. impaired limits
4. other-directedness
5. over vigilance / inhibition
Psychological Interventions for Complex Problems 3
, ST in Practice
→Coping
fight- flight- freeze
overcompensation - avoidance - surrender
Bio-psycho-social model: Development of schemas and
symptoms/complaints
Psychological Interventions for Complex Problems 4