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‘Teaching Me to Parent Myself’: The Feasibility of an In-Patient Group Schema Therapy Programme for Complex Trauma

Published online by Cambridge University Press:  07 December 2017

Rita Younan
Affiliation:
The Victoria Clinic, Prahran, VIC, Australia and Schema Institute Australia, Carlton, VIC, Australia
Joan Farrell
Affiliation:
Center for BPD Treatment and Research and Indiana University/Purdue University – Indianapolis, USA
Tamara May*
Affiliation:
Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia Murdoch Children's Research Institute, Parkville, VIC, Australia Deakin Child Study Centre, Deakin University, Burwood, VIC, Australia
*
Correspondence to Tamara May, 221 Burwood Highway, Burwood, Victoria, Australia, 3125. E-mail: tamara.may@deakin.edu.au

Abstract

Background: Group schema therapy is an emerging treatment for personality and other psychiatric disorders. It may be particularly suited to individuals with complex trauma given that early abuse is likely to create maladaptive schemas. Aims: This pilot study explored the feasibility and effectiveness of a 4-week in-patient group schema therapy programme for adults with complex trauma in a psychiatric hospital setting. Method: Thirty-six participants with complex trauma syndrome participated in this open trial. Treatment consisted of 60 hours of group schema therapy and 4 hours of individual schema therapy administered over 4 weeks. Feasibility measures included drop-out rates, qualitative interviews with participants to determine programme acceptability and measures of psychiatric symptoms, self-esteem, quality of life and schema modes pre-, post- and 3 months following the intervention. Results: Drop-out rate for the 4-week program was 11%. Thematic analysis of interview transcripts revealed four major themes: connection, mode language explained emotional states, identifying the origin of the problem and the emotional activation of the programme. Measures of psychiatric symptoms, self-esteem and quality of life showed improvement post-treatment and at 3 months post-treatment. There was a reduction in most maladaptive schema modes pre-/post-treatment. Conclusions: A group schema therapy approach for complex trauma is feasible and demonstrates positive effects on psychiatric symptoms and maladaptive schemas.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, fourth edition, text revision). Washington DC: American Psychiatric Association.Google Scholar
Anderson, N. B. (2006). Evidence-based practice in psychology. American Psychologist, 61, 271285.Google Scholar
Australian Bureau of Statistics (2013). Census of population and housing: Socio-economic indexes for areas (SEIFA), Australia. Canberra, ACT, Australia: ABS.Google Scholar
Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Gusman, F. D., Charney, D. S. and Keane, T. M. (1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress, 8, 7590.Google Scholar
Boulet, J. and Boss, M. W. (1991). Reliability and validity of the Brief Symptom Inventory. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3, 433.CrossRefGoogle Scholar
Braun, V. and Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77101.CrossRefGoogle Scholar
Briere, J. and Runtz, M. (1993). Childhood sexual abuse long-term sequelae and implications for psychological assessment. Journal of Interpersonal Violence, 8, 312330.CrossRefGoogle Scholar
Cloitre, M., Courtois, C. A., Charuvastra, A., Carapezza, R., Stolbach, B. C. and Green, B. L. (2011). Treatment of complex PTSD: results of the ISTSS expert clinician survey on best practices. Journal of Traumatic Stress, 24, 615627.Google Scholar
Courtois, C. A. (2008). Complex trauma, complex reactions: assessment and treatment. Psychological Trauma: Theory, Research, Practice and Policy, S (1), 86–100. http://dx.doi.org/10.1037/1942-9681.S.1.86Google Scholar
Courtois, C. A. and Ford, J. D. (2009). Treating Complex Traumatic Stress Disorders: An Evidence-Based Guide. Cambridge University Press.Google Scholar
Crandal, R. (1973). The measurement of self-esteem and related constructs, pp. 8082 in Robinson, J. P. and Shaver, P. R. (eds), Measures of Social Psychological Attitudes, revised edition. Ann Arbor: ISR.Google Scholar
Derogatis, L. R. and Melisaratos, N. (1983). The brief symptom inventory: an introductory report. Psychological Medicine, 13, 595605.Google Scholar
Dickhaut, V. and Arntz, A. (2014). Combined group and individual schema therapy for borderline personality disorder: a pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 45, 242251.CrossRefGoogle ScholarPubMed
Farrell, J. M., Reiss, N. and Shaw, I. A. (2014). The Schema Therapy Clinician's Guide: A Complete Resource for Building and Delivering Individual, Group and Integrated Schema Mode Treatment Programs. John Wiley and Sons.CrossRefGoogle Scholar
Farrell, J. M. and Shaw, I. A. (2012). Group Schema Therapy for Borderline Personality Disorder: A Step-by-Step Treatment Manual with Patient Workbook. John Wiley and Sons.CrossRefGoogle Scholar
Farrell, J. M., Shaw, I. A. and Webber, M. A. (2009). A schema-focused approach to group psychotherapy for outpatients with borderline personality disorder: a randomized controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 40, 317328.Google Scholar
First, M. B., Gibbon, M., Spitzer, R. L., and Benjamin, L. S. (1997). User's Guide for the Structured Clinical Interview for DSM-IV Axis II Personality Disorders: SCID-II. American Psychiatric Publishing.Google Scholar
Ford, J. D. and Courtois, C. A. (2009). Defining and understanding complex trauma and complex traumatic stress disorders. Treating Complex Traumatic Stress Disorders: An Evidence-Based Guide, pp. 1330.Google Scholar
Giesen-Bloo, J., Van Dyck, R., Spinhoven, P., Van Tilburg, W., Dirksen, C., Van Asselt, T. et al. (2006). Outpatient psychotherapy for borderline personality disorder: randomized trial of schema-focused therapy vs transference-focused psychotherapy. Archives of General Psychiatry, 63, 649658.Google Scholar
Herman, J. L. (1992). Complex PTSD: a syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5, 377391.Google Scholar
Jacob, G. A. and Arntz, A. (2013). Schema therapy for personality disorders – a review. International Journal of Cognitive Therapy, 6, 171185.Google Scholar
Lobbestael, J., Van Vreeswijk, M. F. and Arntz, A. (2008). An empirical test of schema mode conceptualizations in personality disorders. Behaviour Research and Therapy, 46, 854860.CrossRefGoogle ScholarPubMed
Marieke, C., Abma, T. A., Bamelis, L. and Arntz, A. (2011). Personality disorder patients’ perspectives on the introduction of imagery within schema therapy: a qualitative study of patients’ experiences. Cognitive and Behavioral Practice, 18, 482490.Google Scholar
Nenadić, I., Lamberth, S. and Reiss, N. (2017). Group schema therapy for personality disorders: a pilot study for implementation in acute psychiatric in-patient settings. Psychiatry Research, 253, 912.Google Scholar
Pennebaker, J. W. and Susman, J. R. (1988). Disclosure of traumas and psychosomatic processes. Social Science and Medicine, 26, 327332.CrossRefGoogle ScholarPubMed
Reiss, N., Lieb, K., Arntz, A., Shaw, I. A. and Farrell, J. (2014). Responding to the treatment challenge of patients with severe BPD: results of three pilot studies of inpatient schema therapy. Behavioural and Cognitive Psychotherapy, 42, 355367.Google Scholar
Rosenberg, M. (1965). Society and the adolescent self-image. Princeton University Press, New Jersey.Google Scholar
Skewes, S. A., Samson, R. A., Simpson, S. G. and van Vreeswijk, M. (2014). Short-term group schema therapy for mixed personality disorders: a pilot study. Frontiers in Psychology, 5.Google Scholar
World Health Organization (WHO) (1996). WHO QOL-BREF: introduction, administration, scoring and generic version of the assessment: field trial version, December 1996.Google Scholar
Young, J. (1990). Practitioner's resource series. Cognitive Therapy for Personality Disorders: A Schema-Focused Approach. Sarasota, FL: Professional Resource Exchange.Google Scholar
Young, J., Arntz, A., Atkinson, T., Lobbestael, J., Weishaar, M., Van Vreeswijk, M. and Klokman, J. (2007). The schema mode inventory. New York: Schema Therapy Institute.Google Scholar
Young, J. E. and Brown, G. (1994). Young schema questionnaire. Cognitive Therapy for Personality Disorders: A Schema-Focused Approach, pp. 6376.Google Scholar
Young, J. E., Klosko, J. S. and Weishaar, M. E. (2003). Schema Therapy: A Practitioner's Guide. Guilford Press.Google Scholar
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