Towards Resilience in ST-CA: How to empower the Clever-Wise mode in Children and Young Adults in inpatient and outpatient treatment
Schema Therapy has become a hot topic within Cognitive Behavioural Therapy (CBT) and the world of Psychotherapy in general. Method. In the following Pre-Conference Workshop, we would like to extend the meaning of “Schema Therapy” to a level from where we can strengthen and foster the acquisition of positive attitudes, functional modes and positive schemas in inpatient as well as outpatient treatment. As an example we will present the inpatient schema-/modebased therapy in a 16-year-old adolescent with school absenteeism and demonstrate how positive-based schema therapeutic techniques can be adapted to the specific needs of school avoiding patients with internalizing symptoms. Goal. The goal is to reinforce the client’s/patient‘s positive experiences, e.g. by supporting them to get in touch with their strengths (Clever-Wise mode) and to connect them (internally) with significant others in their lives (e.g. helpful peers, parental caregivers, and significant others). Conclusion. Beside the basic steps within this positive Schema Therapy approach, the workshop offers many practical demonstrations through picture and video material or life demonstrations, and small exercises allow the participants to transfer the content into their own practice.
Schema Therapy for Children and Young Adults with Autism Spectrum Disorder (ASD)
Background.
In previous treatment approaches for young people with autism spectrum disorder (ASD), the disorder-specific emotional needs, schemas, modes and coping strategies play no or a subordinate role. Schema therapy for this group of clients is relatively new, and therefore requires a more differentiated perpective and extension to the usual practice within Schema Therapy.
Method/Goal.
In this Skills Class, typical schemas and modes in clients with ASD will be elaborated and a ASD-specific mode concept will be introduced. Typical hurdles within the ASD-specific treatment will be described, classified and solution paths will be discussed. For parents and other caregivers, schema therapy provides two starting points. On the one hand, the mode model offers a new framework for an understanding of ASD-specific problems including socio-emotional issues. On the other hand, the clients typical behavioural patterns can be better understood, classified, and, if necessary, modified in an appropriate, individual way. Finally, typical mode clashes between parental caregivers and ASD clients are discussed, completed by guidelines to support parents in strengthening their caring-and-guidance mode (Healthy Adult). This ASD-specific approach is highlighted by the dynamic interplay between warm and nurturing parenting on one side, and empathic confrontation on the other side.
Conclusion.
The schema therapeutic treatment of ASD clients requires a special consideration of the disorder-specific particular needs, accompanied by a mode- and schema-based treatment within CBT protocols that is supported by the system in which the client lives (e.g. family).
Happy, healthy, wise - Meeting and strengthening adaptive modes in children, adolescents and young adults
Participants: Clinical practitioners working with children, adolescents and young adults. Basic experience in Schema Therapy is required.
Background: It’s always a beautiful moment when we encounter an adaptive – playful, creative, competent or even wise – mode in a therapy session. Focusing on competent modes can not only support patients’ positive self-perception. Furthermore, the therapeutic relationship can gain a lot from experiencing and sharing joy, lightness, strength, warmth or inner calmness. As children’s and adolescent’s schemas and modes are still developing, therapists have a great opportunity to specifically build positive schemas and healthy modes, thus supporting the completion of developmental tasks. We meet and activate different adaptive modes: The happy child mode indicates that emotional needs are sufficiently met. In happy child mode, a state of flow can be experienced. Creative and playful impulses are expressed. The competent mode allows problem-solving, socially competent behavior, compassion as well as self-regulation. In patients with traumatic experiences and developing personality disorders, the resilient mode can be understood as a competent mode that has developed despite adversities. The inner helper can be defined as an adaptive parent-mode or adaptive peer-mode, which enables individuals to be self-compassionate and practice mindfulness. Focusing on positive schemas and healthy modes, broadens the treatment indication for schema therapy in children and adolescents. Therapists can build and strengthen resources, self-regulation and socially adaptive behavior in patients with lower risk of developing strong critical or dysfunctional modes. Additionally they can use this approach while treating children and adolescents who have experienced multiple difficulties, severe frustration of emotional needs and toxic relationships. For these patients, especially with trauma and emerging personality-disorders, strengthening the resilient mode (as a variation of the competent mode) and the inner helper can balance maladaptive schema’s impact on young patients’ development. Positive schemas and adaptive modes can be addressed by a variety of interventions with children, adolescents and their caregivers and also be strengthened in the context of the therapeutic relationship.
Teaching Methods: The workshop starts with a brief look at the connection between resources, resilience, post-traumatic-growth and positive schemas, identifying factors that allow flow-experience, self-regulation, social skills and (self-)compassion in adaptive modes. The main part of the workshop focuses on interventions, strengthening and activating adaptive modes – the happy child mode, the competent or resilient mode and the inner helper. Play-therapy, mode-oriented social-skills training, imagery and schema coaching for parents are applied. Strategies to build self-regulation, socially competent behavior and interventions to promote self-compassion are demonstrated and practiced. Options to address healthy modes in the therapeutic relationship are outlined.
Learning objectives
- Strengthening positive schemas and adaptive modes by using creative techniques
- Using mode-oriented social skills training to strengthen the competent or the resilient mode
- Activating the happy child mode by play and improvisation
- Enhancing self-compassion by building up and activating a helper-mode in imagery and play-therapy
- Promoting positive parent-child-interactions by supporting parents in using mindful communication
Addressing positive schemas and healthy modes in therapeutic relationship
Developing the wise child part through the younger years
Gal Geffen
Janine Peckham
Ida ShawDeveloping the wise child part through the younger years As Schema Therapist our role is to meet the core emotional needs of the Vulnerable Child together with the wise or healthy part of our patient. As our patients grow into adulthood, we hope that they have a strong Healthy Adult side that can show empathy to the self and others, have a balanced perspective, can be kind and compassionate to themselves and those around them and have healthy and fruitful personal relationships where they can get their needs met in adaptive ways. But how do we help our younger patients develop their wise or healthy parts as they travel through childhood into adolescents and then onto adulthood? How do we first, identify a young person’s wise part which presents differently through the developmental phases and then how do we, as schema therapists, work with our young patients to develop their wise side? We are excited to share our knowledge and strategies to help you help your young patients grow into healthy adults. even individual therapist could benefit from this workshop by using similar strategies with their adult, healing the VC and strengthening the HA. We will share our knowledge through, case studies and roleplay and give you, the participant, a chance to practice some clinical skills. Our agenda for our workshop is as follows: Understanding the wise part through the developmental phases Understanding how to strengthen this part in age-appropriate ways. Presenting video role plays to demonstrate this with a young patient, under 10 years and an adolescent. Time to practice. Participants will have a chance to practice some skills.
ST-CA in Groups, Concepts and Experiences
Abstract: **Please click on the speakers to check the individual presentations included in the symposium- The Checker Club – Group Schema Therapy for Children aged 6-12Dr. Marion Pothmann
- Understanding the Wise Mode: Group Work with Children and Adolescents. Sergio Morales
- Combination of Individual- and Group-Schema-Therapy in an Inpatient Setting for Adolescents with Depressive and Anxiety Disorders
Ursula Neumann
Creative Ways to Strengthen the Wise and Competent Mode in a Group ST-CA setting
Target audience: Beginners and Intermediate
Abstract: This Skill Class reveals/shows the design of a protocol for working in Group Schema Therapy with children and adolescents and provides information, methods and strategies with which to build a flexible and developmentally appropriate group programme. It focuses on the development of the Competent Mode, which is the primary resource for children’s and adolescents’ emotional, cognitive and social skills and competencies. As the stages of the protocol are presented, those types of interventions and activities that have yielded outstanding results over the years of practice will be highlighted. The methods presented will be those specific to the ST group protocol, with a focus on combining experiential techniques with creativity, playfulness and novelty. The Wise and Competent Modes will be the basic pillars around which we will weave novel experiential strategies for skill building that will support the development of the future Healthy Adult.
The main topics of the workshop are:
1. Recognising the importance of group setting in developing cognitive, emotional, and social skills. It is very important how we think about the structure of a programme focused on the development of the Competent Mode skills according to different criteria, such as age, type of client, objectives.
2. Highlighting the main group-specific factors which influence the makeup of a group with a focus on the importance of the age criteria.
3. Pinpointing the ST-CA objectives in group protocols with a constant focus on the Wise and the Competent Mode in each stage of the protocol: creating a warm, protective environment, developing basic emotional skills: awareness, expression, regulation.
4. Identifying modes, exploring origins, identifying triggers, gaining awareness of the effect of modes in everyday life, specific work with modes and transfer to everyday life
5. Exploring and describing the main areas of competence reflected in the Wise and the Competent Mode and developing them through various group techniques.
6. Showcasing creative ways to increase the Wise and the Competent Modes
7. Reflecting on possible studies designs that could validate this protocol.
Association between Resilience and Positive and Negative Schemas using the Good Enough Parenting Model
Families and society in general face enormous burdens arising from children with problematic behaviours. Fortunately, studies have shown the benefits of parenting interventions that are able to reduce such behaviour (Bonin et al., 2011; Herman et al., 2015;; O’Neill et al., 2013). Given these benefits, it is hugely advantageous to explore ways to educate parents and help them take balanced and holistic preventative measures. An evidenced based early intervention parenting program called “Good Enough Parenting” (GEP; Louis & Louis, 2020), which incorporates schema therapy principles, has been developed to equip parents with step by step guide on how to meet core emotional needs in children. The deprivation of core emotional needs is theorized in schema therapy to be associated with the development of rigid, active negative schemas. Conversely, meeting these needs are associated with the development of positive schemas. To-date, GEP is the only evidenced based parenting program (Louis et al., 2021; Louis & Louis, 2020) with a dual focus on both the positive and negative schemas plus core emotional needs. Positive schemas have been found to be associated with resilience both directly and indirectly (Chi et al., 2022) whereas negative schemas especially vulnerability and dependence have been found to be negatively associated with resilience (Faraji et al., 2022). The three psychometrically validated instruments developed by the presenter – The Young Positive Schema Questionnaire (Louis et al., 2018a), The Positive Parenting Schema Inventory (Louis et al., 2018b), and the latest version of the Young Parenting Inventory – R3 (Louis et al., 2022) measure positive schemas, and positive and negative parent-child interactions respectively; these will be discussed in full. This session will position clinicians and parents to better implement preventative measures, especially targeting early years in children as this has shown to provide the greatest benefits (Heckman, 2013).