Schema Therapy for Borderline Personality Disorder

by Arntz, Arnoud; van Genderen, Hannie; Drost, Jolijn

• ISBN13: 9780470510803
• ISBN10: 0470510803
• Edition: 1st
• Format: Hardcover
• Copyright: 2009-03-16
• Publisher: Wiley-Blackwell

Summary

The book was first published in Dutch by Uitgeverij Nieuwezijds - this book is an English language translation, translated from the original Dutch Language version by Jolijn Drost. The book offers a conceptual model of BPD, a treatment model and an array of methods and techniques for treating BPD clients. It covers treatment planning, the therapeutic relationships, cognitive and behavioural techniques, specific strategies, behavioural pattern breaking and the termination of therapy. The appendices contain handouts for patients including a biographical diary, forms for homework assignments and problem solving and a positive self statement log.

Author Biography

Arnoud Arntz, PhD, is a full professor of Clinical Psychology and Experimental Psychopathology at Maastricht University. He is Scientific Director of the University’s Research Institute of Experimental Psychopathology and Director of the Postgraduate Clinical Psychology Programme in the south of the Netherlands. He is also associated as a psychotherapist with the Maastricht Community Mental Health Centre. He was project leader of the Dutch multi - centre trial comparing schema therapy with transference - focused psychotherapy. One of his main research interests is Borderline Personality Disorder (BPD). Hannie van Genderen, MPhil, is Clinical Psychologist, Psychotherapist and Supervisor of the Dutch Association for Behavioural and Cognitive Therapy. She is a psychotherapist at the Maastricht Community Mental Health Centre and has been involved in the treatment of personality disorders for more than 15 years. She has taught cognitive behaviour therapy in postgraduate programmes for more than 20 years and has developed specialized courses in schema therapy for BPD and other personality disorders.

Table of Contents

About the Authors	p. xi
Preface	p. xiii
Acknowledgements	p. xv
Introduction	p. 1
Borderline Personality Disorder	p. 3
What is Borderline Personality Disorder?	p. 3
Prevalence and Comorbidity	p. 4
Development of BPD	p. 5
Schema Therapy for Borderline Personality Disorder	p. 7
The Development of Schema Therapy for Borderline Personality Disorder	p. 7
Research Results	p. 8
(Contra-) Indications	p. 9
Rationale of Treatment/Theories Supporting Treatment	p. 10
Schema Modes	p. 11
The detached protector	p. 14
The abandoned/abused child	p. 16
The angry/impulsive child	p. 17
The punitive parent	p. 18
The healthy adult	p. 19
Summary	p. 20
Treatment	p. 21
Structure of Treatment	p. 22
Phases in Treatment	p. 24
Starting Phase and Case Conceptualization	p. 24
Developing a relationship and gathering information	p. 25
Measurements	p. 26
Explaining the treatment rationale	p. 27
Treating Axis-I Symptoms	p. 27
Crisis Management	p. 28
Therapeutic Interventions with Schema Modes	p. 28
Treating Childhood Traumas	p. 28
Changing Behavioural Patterns	p. 29
Ending Therapy	p. 29
The Therapeutic Relationship	p. 31
Limited Reparenting	p. 31
Good care	p. 33
Giving direction	p. 33
Empathic confrontation	p. 35
Role playing and role reversal	p. 36
Setting limits	p. 37
Therapists' Schemas and Self-Disclosure	p. 41
Cognitive Techniques and the Therapeutic Relationship	p. 44
Behavioural Techniques and the Therapeutic Relationship	p. 46
Summary	p. 47
Experiential Techniques	p. 49
Imagery	p. 49
Applications and aims of imagery	p. 49
Imagery of a safe place	p. 51
Imagery Rescripting	p. 54
Basic model for imagery rescripting during the first part of the therapy	p. 55
Phase 1: Imagining the original situation	p. 55
Phase 2: Rescripting by the therapist	p. 57
Imagery Rescripting in the Second Part of Treatment	p. 61
Phase 2: Rescripting by the patient as a healthy adult	p. 62
Variations with a patient only partially capable of being in the healthy adult mode	p. 63
Phase 3: Rescripting experienced by the child	p. 63
Imagery Rescripting: Changing Behaviour Patterns	p. 65
Problems with Using Imagery Rescripting	p. 67
Role Play	p. 70
Historical role play	p. 71
Phase 1: The original situation	p. 72
Phase 2: Role switching	p. 73
Phase 3: Rescripting	p. 75
Common problems with historical role play	p. 77
Role play of a current situation	p. 78
Two-or-more-chair Technique	p. 79
Two-chair technique for the punitive parent	p. 79
Problems with using the two-chair technique with the punitive parent	p. 83
The two-chair technique with the detached protector	p. 84
Problems with using the two-chair technique with the detached protector	p. 85
Multiple-chair technique	p. 86
Two-or-more-chair technique with changing schemas and coping strategies	p. 87
Experiencing and Expressing Emotions	p. 87
Anger	p. 88
Experiencing and expressing other emotions	p. 90
Letter writing	p. 91
Cognitive Techniques	p. 93
The Socratic Dialogue	p. 97
Evaluation on a Visual Analogue Scale	p. 97
Multidimensional Evaluation	p. 100
Two-Dimensional Reproductions of Supposed Connections	p. 102
Pie Chart	p. 103
Courthouse Method	p. 104
Historical Testing	p. 105
Flashcards	p. 105
Positive Logbook	p. 106
Behavioural Techniques	p. 109
Experiments	p. 110
Skills Training and Role Play	p. 110
Problem Solving	p. 111
Discussing Dangerous Behaviours	p. 111
Discussing New Behaviours	p. 112
Specific Methods and Techniques	p. 115
Homework	p. 115
Pharmacological Therapy	p. 117
Crisis	p. 118
Suicide and Self-Injury	p. 120
Self-injury and other self-destructive behaviours	p. 120
Suicide	p. 121
Trauma Processing	p. 122
Problems with Processing traumas	p. 123
Methods per Mode	p. 125
Treatment Methods for the Detached Protector	p. 126
Therapeutic relationship	p. 126
Feeling	p. 126
Thinking	p. 127
Doing	p. 127
Pharmacotherapy	p. 128
Obstacles	p. 129
Treatment Methods for the Abandoned and Abused Child	p. 130
Therapeutic relationship	p. 130
Feeling	p. 130
Thinking	p. 131
Doing	p. 131
Obstacles	p. 132
Treatment Methods for the Angry/Impulsive Child	p. 133
Therapeutic relationship	p. 133
Feeling	p. 134
Thinking	p. 134
Doing	p. 134
Pharmacotherapy	p. 135
Obstacles	p. 135
Treatment Methods for the Punitive Parent	p. 136
Therapeutic relationship	p. 136
Feeling	p. 136
Thinking	p. 137
Doing	p. 138
Obstacles	p. 138
Treatment Methods for the Healthy Adult	p. 139
Therapeutic relationship	p. 139
Feeling	p. 140
Thinking	p. 140
Doing	p. 140
Obstacles	p. 141
A Simultaneous Chess Play in a Pinball Machine	p. 141
Final Phase of Therapy	p. 145
Behavioural Pattern-Breaking	p. 145
Ending Therapy	p. 146
Conclusion	p. 147
Brochure for Patients: Schema Therapy for People with Borderline Personality Disorder	p. 149
Cognitive Logbook for Modes	p. 155
Positive Logbook	p. 157
Historical Testing	p. 159
Experiments	p. 161
Homework Form	p. 165
Problem Solving	p. 167
Changing Behavioural Patterns	p. 169
Eighteen Schemas (Young et al., 2003)	p. 171
Coping Strategies	p. 179
References	p. 181
Further Reading	p. 185
Index	p. 191
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