Liam Spicer is a Psychologist, Academic and Researcher based in Tasmania, Australia. He is an EMDR Consultant and Training Facilitator, and works in private practice with children, adolescents, and adults. Liam is actively involved in both training and research in the areas of trauma, grief, suicide, alexithymia, neurodivergence, EMDR, and schema therapy. He recently contributed to the International Handbook of Child and Adolescent Grief and has published in peer reviewed journal articles. He has published in the area of Schema Therapy and has is the lead researcher/author on two current projects including a qualitative exploration of schema therapists confidence and the impact on their therapeutic work, and the schemas and modes of neurodivergent individuals. Liam’s current PHD at Curtin University, Perth is focused on the use of Schema Therapy for Prolonged Grief. This involves exploring the schemas and modes in those with prolonged grief, interviewing schema therapy and grief experts to inform the development of a schema therapy for grief intervention, and also testing a schema therapy for prolonged grief intervention through a case series design. Liam has recently published in the ISST bulletin on the application of Schema Therapy for Prolonged Grief. He has presented at various national conferences and events, and he currently holds a position at the University of Tasmania teaching clinical psychology skills to students.
Integrating Schema Therapy and EMDR with Autistic and ADHD Clients
Research has demonstrated that up to 70% of Autistic and ADHD people are estimated to have a co-occurring mental health condition (e.g., anxiety, depression, anorexia etc., Lai et al., 2019). Autistic and/or ADHD people have also been demonstrated to be at increased risk of experiencing a range of adverse life experiences and subsequent negative life outcomes (El Ayoubi et al., 2021; Schwartz et al., 2023; Rumball et al., 2019). For example, people with ADHD are 3-5 times more likely than non-ADHD peers to report clinically significant PTSD symptoms (Miodus et al., 2021). Furthermore, research has demonstrated that autistic individuals are more likely to experience traumatic events that may not meet the Criteria A for PTSD in the DSM-V such as extreme bullying, grooming, and various restrictive practices. Furthermore, Kerns et al., (2022), demonstrated that some autistic individuals due to social communication differences may not understand that what they have experienced is abuse, or that what has happened to them is “wrong”. Neurodivergent individuals are also shown to be more likely to develop clinically significant mental health challenges after stressful experiences due to underlying vulnerabilities such as a predisposition to anxiety, likelihood of social isolation, and experiences of bullying, demonstrating the interplay between individual differences, adverse childhood experiences, and mental health challenges (Stewart et al., 2020).
Presentation Focus: When assisting Autistic and ADHD clients in therapy with presenting comorbid mental health concerns, interventions need to be adapted not only to their needs, but also to their neurotype, the unique way they process information, connect with others, and experience the world from a sensory perspective. Increasing awareness on the importance of highly individualized treatment options combining evidence based therapeutic modalities with this population is rapidly growing. Both EMDR and Schema Therapy have shown some preliminary evidence for assisting Autistic and ADHD clients with their mental health challenges (Diest et al., 2022; Fisher et al., 2022, Oshima et al., 2021), however further research is needed. In this presentation, the mental health outcomes and challenges of those who are autistic, and ADHD will be presented demonstrating the increased risk this population is at regarding mental health and the experiences of trauma. The research regarding the Schemas of this population will also be presented to provide some foundational knowledge to clinicians in this area. The focus will then direct to various schema therapy and EMDR based interventions that can be useful in assisting this client group, and the modifications to these interventions that are needed. This will include discussing variations to exercises such as chair work, imagery rescripting, using EMDR for trauma reprocessing, and adjustments to therapeutic delivery and the therapy space to create an attuned relationship with this client group. Discussion will also focus on the importance of needs meeting and limited reparenting with this group and focus on the context of their developmental environment as to why not being identified as being autistic and/or ADHD may have further magnified early needs not being met.
The schema and schema modes associated with prolonged grief symptoms: How our schemas and schema modes impact on our experience of grief
This poster presentation will present these latest research findings to enhance clinicians’ knowledge when working in this important area.
Background: Research has demonstrated that 7 to 10% of the bereaved population experiences a more complicated form of grief referred to as prolonged grief disorder (PGD) (Aoun et al., 2015). PGD may last years without improvement, and has been associated with numerous mental health, social, and occupational difficulties. In aim to understand this grief response, research has examined factors associated with a likelihood of developing PGD after the death of a significant other. These include childhood trauma, prior loss, insecure attachment, and the nature of the relationship with the deceased (He et al., 2014; Schaal et al., 2010). Some preliminary research has also demonstrated that our schemas may have an impact on our experience of grief (Thimm & Holand, 2016), however the impact of our schema modes has not been investigated.
Methods: Over 200 individuals over the age of 18 from over 10 countries have completed the research so far. Participants completed the Young Schema Questionnaire-Revised, Schema Mode Inventory and Prolonged Grief Inventory-13. The analysis will have a focus on the potential moderating/mediating role of various modes in the relationship between someone’s schemas and the level of prolonged grief symptoms someone experiences. For example, if someone has a stronger healthy adult mode does this then result in less prolonged grief despite the presence of certain schemas. Conversely, if someone has strong detached, or avoidant modes, does this further impact on prolonged grief symptoms and adaptively being able to adjust to the loss.
Results: Preliminary analysis so far has demonstrated that those who sacrifice their own needs, have a strong sense of abandonment, those who disconnect from emotions, and people who feel like they do not have a strong sense of self have higher levels of grief symptomology (full analysis to be completed in the next two months). The results also explore the roles of various schema modes, and the role they play in this relationship.
Conclusion: This research is the first of its kind worldwide to explore the relationship between our schema, schema modes, and the impact on grief symptoms. This gives us greater understanding of risk factors, and also informs the development of clinical interventions. From understanding what modes may be impacting on the relationship between schemas and grief, preventative approaches around building up healthy adult and child modes can be implemented to enable a person to be able to grieve more proactively and adaptively.
Impact Statement: Findings from this research may culminate in clinical recommendations to improve outcomes for individuals with prolonged grief, and better inform evidence-based treatment decisions in clinical practice. This research will be followed by the development of a schema therapy for prolonged grief treatment. Due to the future projected increases in the prevalence of PGD (Eisma et al., 2020), the development of effective treatment approaches tailored to a client’s needs is of great importance.