Schema Therapy Flashcards
4 therapy components of schema therapy?
- Limited reparenting (empathic confrontation, positive regard, guidance)
- Cognitive techniques
- Emotional/experiential (chair work, imagery rescripting)
- Behavioural pattern breaking
5 differences between schema and CBT?
- Greater emphasis on therapeutic relationship
- Longer treatment
- Greater emphasis on affect (through imager, role playing) and mood states
- Childhood origins and developmental processes
- Core themes (schemas) over symptom reduction
What are 4 qualities of early maladaptive schemas?
- Pervasive pattern of memories, emotions, cognitions
- Regarding oneself and relationship with others
- Developed during childhood/adolescence and perpetuated
- Dysfunctional (but functional at origin)
How are EMSs developed?
Core emotional needs + Early environment + emotional temperament = EMS
List some EMSs? Give examples.
Abandonment Mistrust/abuse Emotional deprivation Defectiveness Dependence Vulnerability to harm Enmeshment Failure Entitlement Insufficient self-control Approval-seeking Subjugation Self-sacrifice Unrelenting standards Negativity / pessimism Emotional inhibition Punitiveness
What are the 3 schema coping styles?
Give two clinical examples of each.
- Surrender (freeze)
- Compliance
- self-blame/punishment - Avoidance (flight)
- Dietary restriction
- Bingeing, purging
- Substance use
- Detachment
- self-harm
- Social withdrawal
- stimulation/workaholism
- Distraction (gaming, gambling) - Overcompensation (fight)
- Perfectionism
- Over control
- Excessive self reliance
- Demandingness
- Manipulation
- Competitiveness
- Aggression/hostility
- Recognition-seeking
Name 5 child modes?
- Vulnerable
- Angry
- Lonely
- Impulsive
- Happy
What is the Healthy Adult mode?
Client’s healthy side –that is compassionate, limit-setting, nurturing, assertive, wise and empathic.
Name the coping mode: Emotional detachment to protect from painful feelings, numb, distant, avoid closeness
Detached protector
Name the coping mode: Repetitive behaviours to calm/sooth, exciting behaviours to distance from pain. Addiction.
Detached self-soother
Name the coping mode: Wall of anger to protect from others who are perceived as threatening, safe distance from others (more controlled than Angry Child)
Angry Protector
Name the coping mode: Give into real/perceived expectations of others in attempt to avoid pain/get one’s needs met (e.g. love/acceptance)
Compliant surrenderer
Name the coping mode: Demands in a victimised manner, expresses indirectly as irritation, helplessness, self-pity
Complaining protector
Name the coping mode: Superiority to others, appearances over real feelings/authentic contact
Self-aggrandiser
Name the coping mode: Always striving for order, perfect results and difficulty dealing with uncertainty
Perfectionistic, over-controller
Name the coping mode: Threats, intimidation, aggression, coercion to get needs met. Asserting dominance, sadistic pleasure in attacking others.
Bully/attack
Name the coping mode: Ruminating and exercising extreme control. Repetition or ritual (i.e. OCD)
Paranoid over-controller
Name the coping mode: Eliminating perceived threat, obstacle or enemy. Cold, ruthless, calculating manner.
Predator mode
Name the coping mode: Lies, victimising others, escaping punishment
Conning/Manipulating
Why is schema therapy needed? 3 reasons
- Cognitions and behaviours are more rigid with individuals with PDs
- Intimate problems more common with PDs
- Gap between cognitive and emotional change bigger in those with PDs (“get it but don’t feel it”)
What are the five core emotional needs?
- Secure attachment
- Autonomy, competence and sense of identity
- Freedom to express needs and emotions
- Spontaneity and play
- Realistic limits and self-control
What are repisodes?
Repeated experiences - e.g., every day I come home
and mum is passed out on coach and I’m alone
What happens to healthy adult mode in clients with severe PD?
Can be absent or very weak
How is healthy adult mode modelled?
By the therapist initially, then the client evolves until she can assume this role.
What are schema modes
Cluster of schemas or schema coping styles – adaptive or maladaptive – that are currently active for an individual.
What are the 4 classes of modes?
- Child modes
- Coping modes (e.g., detached protector)
- Internalized parent modes (e.g., demanding parent)
- Healthy adult mode
What are 3 ways to spot schema modes?
- Verbal content; what does the client tell you?
- Non-verbal communication: tone of voice etc.
- Countertransference: what is your primary
emotional reaction to what the client is doing?
Two phases of schema therapy?
- Assessment and education
2. Change phase
What are 4 goals of therapy in the change phase?
- Increase autonomy
- Increase feelings of connectedness to others
- Build self-confidence
- Learn realistic limits and expectations
What is the overall aim of the change phase?
Validate the core needs and restart the emotional development of the client
Limited parenting involves supplying what clients ______ but did not ______ from their parents in childhood.
Limited parenting involves supplying what clients needed but did not receive from their parents in childhood.
What are 4 main parts of limited reparenting?
- Care, understanding, warmth, attunement
- Giving direction and guidance
- Empathic confrontation
- Limit setting
