George Lockwood has been in full time private practice for the past 42 years, 30 of which have been focused on the practice of Schema Therapy. He has been one of the main collaborators with Jeffery Young in the development of Schema Therapy. He is an ISST certified Supervisor and Trainer and has provided training in Schema Therapy beginning in 1996 in California and from 2000 to the present through the Schema Therapy Institute Midwest, of which he is the director. He has continued to be active in clinical practice, research and publishing and has guided and participated in important theoretical and clinical expansions of the schema therapy model including the development of positive schemas.
New Tools and Strategies for Developing Positive Schemas and Modes in Work with Challenging Patients
In this workshop you will learn ways of increasing your effectiveness in developing positive schemas, adaptive child modes and the Healthy Adult Mode in work with complex PTSD and other challenging cases. You will first learn how to expand the scope and depth of your case conceptualization to more fully establish the foundation these adaptive capacities are built upon. You will then learn how to use this understanding to expand a range of strategies, including imagery rescripting, to more directly engage positive child modes and develop positive schemas. This positivity is most fully leveraged within a therapeutic relationship that is drawing upon 8 dimensions of limited reparenting as operationalized in the recently developed Limited Reparenting Inventory (LRI). You will learn what these dimensions are and how to embody them. We will start with an expansion of the assessment of functioning in 5 major life areas included in the current ISST Case Conceptualization Form that includes an additional 6 areas that have strong links to optimal brain functioning and emotional well-being. An overview will be provided of key research findings demonstrating the strength of their impact. Practical guidelines for incorporating them into reparenting will be presented and guidance offered for how to increase your own functioning in each of these areas; a necessary precursor to helping your patients with this. Next a framework and set of tools for a comprehensive assessment of temperament will be provided that includes measures of adult temperament, sensory processing sensitivity and a newly developed measure of retrospective child temperament will be outlined and the ways these inform the development of positive schemas and modes will be discussed. An expansion of the framework for assessing early childhood and adolescence will be provided that helps to identify strengths by clarifying both the ways parents fell short and what they did well. How this is facilitated through the use of the PPSI and YPI-R3, tools to assess adaptive and maladaptive parenting, will be outlined. A set of 8 core emotional needs, a refinement and expansion of the current 5 postulated by Young, will be described, the nature of their empirical support discussed and the ways this refinement helps in developing positive schemas and modes discussed. A framework for the systematic assessment of both negative and positive schemas and the use of the LRI in assessing the quality and strength of the reparenting relationship and in guiding treatment and will be presented. Finally, an overview of the newly emerging frameworks for understanding our most complex mode, the Healthy Adult will be provided and what they tell us about what it is and how to develop it most fully will be discussed and demonstrated. Case examples demonstrating the conceptualization process and the use of these new concepts, tools and frameworks over the course of a full treatment will be presented. This will include video taped examples, experiential exercises, role plays and opportunities for supervised practice of some of the key skills.
The Healthy Adult Mode; Key Similarities and Differences Between four empirical based models and their Clinical Implications
Co-Presented with David Bernstein, John Louis & Guygu Yakin
Four major research based approaches to the development of our understanding of the Healthy Adult Mode will be discussed with a focus on the key areas of overlap, differences, possibilities for integration, clinical implications and suggestions for further development. Each had distinctly different starting points. Yakin and Arntz have been exploring the interactions between healthy adults and child modes. Bernstein cast a broad to develop a model drawing on the work of Seligman, Bowlbly, Frankle, Ryan & Deci and the DSM-5 model of healthy functioning, among others. Louis and Lockwood started with 18 positive schemas hypothesized by Lockwood, Perris and Young as the adaptive counterpoints to the 18 early maladaptive schemas. Louis and Lockwood also developed a second model of the healthy adult mode in a nurturing context with their starting point being hypothesized counterpoints to the maladaptive parenting interactions operationalized in the Young Parenting Inventory. Tilling the soil of healthy adult functioning from such distinct yet compelling directions offers the promise of significantly advancing our understanding of this important and complex construct.
Yakin and Arntz’s work involved in-depth qualitative analysis of the interactions between child modes and healthy adults by conducting 45 to 60 minute semi-structured interviews. Three broad themes and 10 subthemes emerged. Bernstien’s personal strengths model consists of four domains and 16 primary factors and has an accompanying scale for clinical use. Louis and Lockwood’s model of healthy adult functioning consists of 14 positive schemas organized into 4 domains and Louis and Lockwood’s model of the healthy adult parent consists of 7 parenting schemas. Each of these two models have an accompanying scale for clinical use. All four of these models are in the midst of ongoing research and updates on recent findings will be provided.
Conceptualizing and assessing the Healthy Adult within the context of schema therapy practice
Co-presented with David Edwards, Poul Perris, Tijana Mirovic
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.