The origins of the Therapy scheme
The Therapy scheme (St; Young, 1990; Young, Klosko, & Weishaar, 2003) was born and proposed itself as an effective and useful supplementary model for the purposes of the conceptualization and treatment of resistant disorders, chronic and personality.
While having its roots in cognitive-behavioral therapy, the ST has integrated with different concepts of different theoretical matrices (for example psychoanalytic, gestaltic, transactional, attachment).
The approach is based on the concepts of “dissatisfied primary need“And” early maladative scheme “(SMP), which are considered the main responsible for the suffering presented by patients. They derive, for example, from experiences of neglect or trauma in childish and adolescent age.
The evolutions of the model
The Therapy scheme has evolved over time, focusing more on the concept of “Scheme Fash“(Van Vreeswijk, Broersen, & Nadert, 2012) rather than SMP.
The Fashor Scheme modeconcerns the set of patterns and related operations (functional or dysfunctional) active in a person at a certain moment.
Compared to cognitive-behavioral therapy, the focus is more oriented on emotional plan and on the exploration of the childhood and adolescent origins of the psychological difficulties presented by patients.
The nuclear elements of the Therapy scheme include the conceptualization model centered on Fasha specific method of therapeutic relationship (“Limited repairing“) And the intensive use of comprehensive techniques (Imagery Rescripting And Chair Work).
The research certifies the Therapy scheme as one of the most effective treatment models for personality disorders.
The most recent approach: Contextual Therapy scheme
Consistent with the supplementary perspective that characterizes the Therapy scheme, some authors have worked to further update the model, integrating it with the most recent evolutions of cognitive-behavioral therapy.
Thus, the Contextual Therapy Scheme (CST; Rodiger, Stevens, & Brockman, 2018): the reference frame within which this model moves remains that provided by the Young model.
Therapeutic strategies that derive from different approaches from cognitive-behavioral models continue to be used. However, the Therapy scheme is revised here in the light of the recent contributions of the “Third generation” of cognitive-behavioral therapyin order to provide psychotherapists and their customers with an even more flexible and effective model.
The theoretical clinical assumptions of the model
The goal is to balance a “second generation” approach (based on the change of the contents of the scheme) with one of “third generation” (modifying the way people relate to their experiences).
Thus, for example, some basic principles of the Accept Therapy (Act; Hayes, Strosahl, & Wilson, 2012) are incorporated and integrated with the widely emotional focus of the Therapy scheme.
In CST, even more importance is given to work directly oriented towards adult functional mode which, however, connects well to the concept of psychological flexibility (Hayes, Strosahl, & Wilson, 2012) and can be “enhanced” using Act strategies.
For example, the integration of techniques deriving from compassion therapies based on Mindfulness, and acceptance, together with the therapeutic relationship, offers therapists precious tools. In ST terms, it allows you to deal with apparently waterproof methods such as typical ones, for example, strong “avoidant and detached protectors”, “hypercompensator bullies” and “submissive surrender” without hope that they give up their needs.
The operational tools of the Contextual Therapy scheme
Thus, they are proposed to the clinicians of the Additional tools useful in order to face and overcome the strong detachment presented by some patients. But also to manage the harmful internal dialogue deriving from demanding and critical “parents” tenacious and to access the most vulnerable fashions, protecting and taking care of it, directly strengthening, at the same time, the “healthy adult” mode.
The ultimate goal remains to combat dysfunctional methods, in favor of healthier and more adaptive responses, consistent with their own needs.
The manual “Contextual Therapy scheme: an supplementary approach to Personality Disorders, Emotional Dysreguulations and Interpersonal Functioning ” It will be available in Italian in November 2020, published by Erickson.
Bibliographic references
- Hayes, SC, Strosahl, KD, & Wilson, Kg (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd ed.). New York: Guilford Press.
- Rodiger, E., Stevens, Ba, & Brockman, R. (2018). Contextual Therapy scheme: an supplementary approach to Personality Disorders, Emotional Dysreguration and Interpersonal Functioning. Oakland: Context Press.
- Van Vreeswijk, M., Broersen, J., & Nadert, M. (2012). The Wiley-Blackwell Handbook of Therapy Schema: Theory, Research, and Practice. West-Sussex: John Wiley & Sons.
- Young, Je (1990). Cognitive Therapy for Personality Disorders: A Scheme-Focused Approach. Sarasota, FL: Professional Resource Exchange.
- Young, Je, Klosko, Js & Weishaar, Me (2003). Therapy scheme: A Practitioner’s Guide. New York: Guilford Press.
