Co-presented with David Edwards, George Lockwood, Poul Perris
This panel discussion will focus on conceptual and practical aspects of the process of assessing a client’s healthy adult functioning in preparation for schema therapy. The Healthy Adult is best thought of as not a single mode, but a suite of healthy capacities or strengths that, when viewed together, characterize how a psychologically mature adult would think, feel and behave towards self and others. The ISST’s 2024 Case Conceptualization Form provides a framework for conceptualizing the Healthy Adult Mode with considerable breadth and depth, using eight broad categories.
David Edwards will discuss how these categories were arrived at. The nature of mature human functioning has always been of interest and concern within psychology and contributions will be reviewed from Alfred Adler’s community feeling, Carl Roger’s fully functioning person, Abraham Maslow’s self-actualizing personality, and those who have drawn on the traditional concept of wisdom as elaborated, for example, in the Berlin wisdom paradigm of Baltes, Linden and others. Within schema therapy, these perspectives are the foundation of Bernstein’s 16 qualities of the Healthy Adult portrayed in a set of illustrated iModes cards. More recently, the DSM-5 and ICD-11 diagnostic systems, in moving away from classifying personality disorders using a limited set of categories, have identified a range of dimensions of mature and healthy functioning which, taken together, offer a view of mature human functioning which is comprehensive, and evidence-based, and does justice to the complexity of human personality.
The eight categories for evaluating the Healthy Adult in the latest ISST case conceptualization form offer an attempt to synthesize these capacities into a manageable form for assessment of the Healthy Adult in clients along dimensions that are clinically relevant in that they directly impact case conceptualization and the effectiveness of therapy interventions.
On the basis of this, Poul Perris will describe a clinical tool for assessing these capacities: “My Healthy Adult Capacities in a specific Life Area/Relationship.” It is based on eight different statements relating to each of the eight categories from the case conceptualization form (64 in all). Based on a development process in which feedback was provided by clients and therapists, he will offer practical guidelines on how to implement this in clinical practice, both in the initial assessment process, and more generally, when conceptualizing the challenges presented by clients whose therapy does not proceed smoothly.
George Lockwood will draw on his experience in contributing to the development of the Positive Parenting Schema Inventory (PPSI) and the Young Positive Schema Questionnaire (YPSQ) and his clinical use of the PPSI, YPSQ and the International Personality Item Pool-NEO in the case conceptualization process to comment further on this discussion and to highlight the practical aspects of evaluating healthy adult functioning within the schema therapy process.
Tijana Mirovic will act as discussant, presenting her reaction to the material presented with a focus on the practical implications and challenges for trainers and supervisors.