Upload
others
View
0
Download
0
Embed Size (px)
Citation preview
From Positive Schemas to Psychosis: New Directions in
Schema Therapy
Dr Rob Brockman, Senior Research Fellow, Institute for Positive Psychology and Education (ACU)Director, Schema Therapy Sydneyschematherapysydney.com.au
Core Change Processes in Schema Therapy
1. Corrective Emotional Experiences (Cognitive AND Emotional Change).
2. Reversing Schema Maintaining Behavioural Patterns.3. Core Emotional Need Satisfaction.4. Building the Healthy Adult Mode.
“mindful here‐and‐now perceptions, an interruption of spontaneous, maladaptive coping behaviour, an emotionally detached reappraisal of internalized parent mode cognitions and at least supportive self‐instructions to induce and maintain functionalcoping.”
Healthy Adult Mode (Roediger, 2012)
Healthy Adult Mode• Is characterised by higher functioning and healthy schemas of capability, strength etc.
• Involves behaviours and cognitions that are required for the undertaking of appropriate adult functions such as taking responsibility, working, parenting, commitment etc.
• The container of Positive Schemas.• Allows individuals to use adaptive approaches to meet their emotional needs.
• Healthier, higher functioning people have a stronger Healthy Adult Mode.
Functions of Healthy Adult Mode
‐ Assists individual to meet previously unmet needs‐ Nurtures, affirms, and protects individual from destructive schemas
‐ Instils self‐discipline to set limits and boundaries on behaviour
‐ Moderates other schema modes‐ Responds flexibly to difficulties.‐ Maps well to psychological flexibility.
Mediation Models(Lazarevic, Brockman, & Hough, 2013)
Punitive Parent
Vulnerable Child
Healthy Adult
PsychologicalFlexibility
PsychologicalFlexibility
In Preparation (Lazarevic, Brockman, & Hough, 2013)
Relationships (uncorrected) between schema modes and psychological flexibility processes
Healthy Adult Mode
Defusion
Mindful
Awareness
AcceptanceValues Clarity
Committed Behaviour
Self‐Compassion
Acceptance
A New Definition of Healthy Adult Mode(Roediger, Stevens, & Brockman 2018)1. Healthy Self‐Content (Healthy Schemas) “I can do this, its OK to
give it a go”2. Healthy Style of Self‐Processing (Self‐Awareness, Mindfulness)Noticing and being aware of what shows up for you “A Part of me is scared and wants to run away right now”
Rationale for Integration of ACT/CBS/3rd Wave Techniques• Traditionally ST focused on ‘Content’• More recently building awareness and HA more directly.• ACT/CBS/3rd wave techniques evidence based for this.• e.g ACT RCTs• Schema therapy integrative as long as fit the purpose and model.• These techniques are promising but how best to integrate them? See new book Contextual Schema Therapy for an Overview.
ACT/CBS Principles and Schema Therapy
• 1. Language can be sticky• 2. The Healthy adult is concerned with long term need satisfaction.• 3. All modes are contextual (understandable)• 4. The goal is flexibility (e.g. pros and cons)• 5. Fighting back against schemas/modes risks (at times) getting caught up in them > possible implication for chair‐work dialogues and imagery dialogues.. More compassionate approaches?
Positive Schemas
14 Positive Schemas (only)
Key Findings
1. There are only 14 positive schemas!2. Two‐Dimensional Model Supported (positive and negative schemas
related but distinct processes; can co‐exist).A Question?How to best build positive schemas? Self‐Compassion? Priming the Healthy Adult Memories Before Rescripting?3. Positive Schemas Related to Positive Outcomes Regardless of Cultural Context.
Avoidance Model of Psychosis/Delusions
Intense emotions/Threat schemas
E.g. “The world is Dangerous”
Delusional Mode
Vulnerable/Angry Child?
Avoidance?
Correlation Matrix (Emily??)
Hypothesised Mode Model of Delusionality
Research Collaborators? PhD Students?
• Positive Schema Questionnaire in Clinical Patients.• Positive Parenting Questionnaire in Clinical Patients.• Cross‐Cultural Applications of Schema Therapy.• New Mode Questionnaire (With all of the modes; Needs Clinical Patients).
• Schema Therapy Techniques (e.g. Imagery Rescripting) for novel populations (e.g. Delusional Patients).
• New Therapy Process Measure (21‐Items) cuts across common processes (transtheoretical) (e.g. avoidance)
Contact
[email protected] (Research)[email protected] (Practice, Supervision, Training)
Discussion Points
• How do we best integrate ACT/3rd Wave Techniques into ST? When/how might this be most appropriate?
• How do we build positive schemas in ST, and make use of this research that suggests building positive schemas is as crucial as healing negative schemas?
• What may be some issues in treating psychotic sx using ST? When m might this approach be most appropriate/promising? When not?
Itinerary8.45am: Intro and Ice Breaker9am: Daniela Ho Tan: Cross Cultural Applications of Schema Therapy9.45am: Melanie Babooram: Schema Therapy and Chronic Pain10.30am: Break10.50am: Andrew Phipps: Therapist Self-Sacrifice11.35am: Claudia Mendez: Schema Therapy for Eating Disorders12.30pm: Break for Lunch1.30pm: Cathy Pearson: Community Mental Health Services and ST Practice2.15pm: Xi Liu: Skype and Schema Practice3pm: Break3.20pm: Rob Brockman: From Psychosis to Positive Schemas and Mindfulness: An Update on Current Schema Therapy Directions4.05pm-4.30pm: Closing and Reflection