Book focuses on Group Schema Therapy for BPD

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Treatment manual and patient workbook

Therapists, patients and families dealing with Borderline Personality Disorder now have an unprecedented guide to a way out of the misery and chaos in the form of the soon to be release book "Group Schema Therapy for Borderline Personality Disorder: Treatment Manual and Patient Workbook". In a series of recent studies ( Giesen-Bloo et al., 2006; Nadort et al., 2009; Farrell, Shaw and Webber, 2009), Schema Therapy (both individual and group forms) has been shown to lead to full recovery across the complete range of symptoms for many patients suffering from Borderline Personality Disorder. Through these studies, Schema Therapy was shown to be more than twice as effective in bringing about full recovery as a widely-practiced traditional treatment (Transference Focused Psychotherapy). Schema Therapy was also found to be more cost-effective and to have a much lower dropout rate. When Group Schema Therapy was added to individual psychotherapy, it was found to lead to even stronger outcomes over a briefer period with a 0% drop out rate and a recovery rate of 94% over a span of 8 months. These promising results have lead to the initiation of a large multi-site international study involving 14 treatment sites spanning 6 countries. Preliminary data from this investigation suggest similarly strong outcomes.

Group Schema Therapy for Borderline Personality Disorder is an outgrowth of training therapists to participate in the multi-site international study and a new window into this powerful approach. It is a total package for practitioners, interested patients and family members in its combination of theoretical, conceptual, empirical and highly practical information. This includes "Therapist tips" for the application of techniques and patient workbook materials accessed on the Wiley website. The principle authors of this book, Joan Farrell, Ph.D. and Ida Shaw, M.A. developed the original Group Schema Therapy model over a period of 25 years and conducted the first randomized controlled trial to test its effectiveness. They are recognized internationally as the primary trainers and supervisors of Group Schema Therapy. While this book is focused on the treatment of Borderline Personality Disorder (BPD) and the all BPD group, like individual ST, Group ST can be adapted to other personality disorders and entrenched interpersonal problems frequently seen in patients suffering from anxiety and depression who present in practice for longer term psychotherapy. Research is underway to test adaptations of this model for Inpatient and Day therapy treatment of BPD, use with other personality disorder patients, mixed groups and the forensic population.

Both individual and Group Schema Therapy are integrative approaches, founded on the principles of cognitive-behavioral therapy, then expanded to include techniques and concepts from other effective psychotherapies. Schema therapists help patients to change their entrenched, self-defeating life patterns - or schemas -- using cognitive, behavioral, emotion-focused, and interpersonal techniques. The treatment focuses on the relationship with the therapist, daily life outside of therapy, and the traumatic childhood experiences that are common in this disorder. Dr. Young, the originator of Schema Therapy, believes its greater effectiveness arises in part from its use of "limited reparenting," which is not part of other approaches to BPD. In individual Schema Therapy it involves the therapist serving as a transitional parental figure who, within the bounds of a professional relationship, works to directly meet core needs in a way that allows the patient to internalize these "healthy adult" capacities and eventually meet his/her own needs. Group Schema Therapy adds to this transitional parental figure a transitional healthy family. The combination of a healthy parent and family seems to augment the effects that each has on their own.

According to Dr. Young: "Other treatments for BPD, such as Dialectical Behavior Therapy, have also led to more effective coping skills and a significant reduction in self-harm. With Schema Therapy patients are, in addition, breaking free of lives of pain, self-hatred, and emptiness, making deeper personality changes, and significantly improving the quality of their lives."

Schema Therapists are hoping that the addition of a group format will make this approach even more cost effective and allow it to be made widely available, allowing clinicians to bring love and fulfillment into the lives of many more patients currently stuck in a miserable existence. There is also hope that the repeated validations of the effectiveness of Schema Therapy will lead to more research studies, encourage more clinicians to learn Schema Therapy and convince healthcare insurers to reimburse the costs of effective longer-term psychotherapy for painful and costly illnesses such as BPD.


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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