A brief overview of schema therapy

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Dr Emma Newton: Consultant Clinical Psychologist and Head of Psychological Services,

Court Hospital

Heatherwood

Heatherwood Court Hospital

Heatherwood Court offers multidisciplinary treatment and rehabilitation for people with complex mental health needs and forensic histories.

❖Chepstow Ward- Male Low Secure

❖Cardigan Ward- Female Low Secure

❖Caerphilly Ward- Female Low Secure

❖Caernarvon Ward-Female Locked

Rehabilitation

Heatherwood Court Hospital- The HUB

Cinema Room Pool

Theme Days

Art Room

Sensory Room

Café

People’s Council

Multi Faith Room

Therapy Rooms

Animal Encounters

Heatherwood Court- Psychology Department

Assessment>Formulation>Intervention>Evaluation

Group/individual models utilised include:

❖ DBT/DBT Skills

❖ CBT/TF-CBT

❖ CFT

❖ MBT

❖ Schema Therapy

❖ Psychoeducation

❖ Readiness to change

Why Schema Therapy?

❖“Many clients who begin schema therapy have sometimes spent years in other types of therapies, gaining valuable insight, but often frustrated by their lack of progress. These clients typically had long-standing, self-defeating patterns or themes in thinking and feeling (and consequently in behaving or coping.”

❖“Schema therapy enables changes in clients who feel hopeless about their self-destructive patterns, because these problematic behaviours may seem so entrenched that they appear to be part of their very identity”.

❖“Schemas or ‘negative life beliefs’ can lead to low self-esteem, lack of connection to others, problems expressing feelings and emotions and excessive worrying about basic safety issues”.

❖“Beginning with a series of assessments clients learn to recognise which schemas and problematic coping styles affect them the most, understand the origins and learn how to make lasting changes”.

Key features of schema therapy

Early Maladaptive Schemas

Schemas are consistent patterns of thoughts and feelings internalised during early in life experiences of having or not having core emotional needs met. When negative experiences and patterns are reinforced throughout a person’s lifetime these thoughts patterns can become increasingly entrenched.

Schema Modes

Schemas can drive and inadvertently be perpetuated by various potential coping styles labelled as schema modes. These reflect in the moment emotion and coping responses.

Coping modes are generally triggered by specific situations relating to a personal vulnerability and potential resulting in an unhelpful response.

Core Emotional Needs

Freedom to express needs & emotions

Secure

Attachment

Spontaneity & Play

Realistic Limits

Autonomy

Early Maladaptive Schemas- Young 2003

Emotional Deprivation

Abandonment

Self-Sacrifice

Mistrust/Abuse

Defectiveness

Social Isolation

Vulnerability

Dependence/Incompetence

Enmeshment/Undeveloped Self

Failure

Approval-Seeking/Recognition-Seeking

Subjugation

Emotional Inhibition

Negativity/Pessimism

Unrelenting Standards

Punitiveness

Entitlement/Grandiosity

Insufficient Self-Control/Self-Discipline

Schema Therapy-Modes

Schema Therapy- key therapeutic approaches

❖Schema Diary Cards

❖Limited Re-parenting

❖Empathetic Confrontation

❖Chairwork

❖Imagery Re-scripting

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