Workshop 3

Schema Therapy Techniques to Enhance Therapeutic Effectiveness with Entrenched & Complex Clinical Presentations

Susan Simpson, Consultant Clinical Psychologist, NHS Forth Valley Specialist Eating Disorder Service, Stirling, and Schema Therapy Training, Scotland

Schema Therapy (ST) is particularly helpful for clients who have become ‘stuck’ and are not improving in response to first-line treatments. Those with problems linked to personality-related difficulties and other lifelong coping patterns tend to experience greater rigidity in their cognitions and behaviours and often struggle to engage in techniques such as those used in standard cognitive behavioural therapy.

ST is a relational model. The therapeutic relationship serves as an antidote to childhood experiences that led to the development of EMS through ‘limited reparenting’. This involves providing experiences, within the bounds of the professional relationship, that provide a secure attachment and fulfil the emotional needs that were consistently unmet during childhood.

This workshop will enable participants to consider ways in which schema therapy techniques may enhance the effectiveness of CBT for people with more complex or ‘dug-in’ difficulties that do not respond to standard methods. By employing powerful experiential techniques such as imagery rescripting and chair work, the therapist can create corrective emotional experiences to challenge the entrenched core beliefs and insecure attachment patterns that drive their clients’ presenting problems.

The workshop will include

• Key features of the Schema Therapy Model & rationale for application with complex clinical presentations
• Strategies for change, with an emphasis on deeper level change with core beliefs/schemas
• An opportunity to practice using powerful methods of addressing unhealthy schemas/core beliefs and shifting highly avoidant coping that can block therapeutic engagement and change
• Case study examples to enable participants to consider how they could apply schema change techniques with their own complex clients.
• Opportunity to think about how they could apply schema change techniques with their own clients.

Key learning objectives:

By the end of this workshop, participants will be able to:

• Describe the rationale for using schema therapy techniques with complex clinical presentations
• Understand the evidence base for schema therapy across a range of clinical problems
• Begin to conceptualise their own clients’ difficulties using ‘schema modes’
• Recognise the four main aspects of change-work that takes place in schema therapy
• Understand the role of experiential techniques (e.g., imagery rescripting, chair work, empathic confrontation) in providing corrective emotional experiences
• Learn preliminary skills in applying powerful experiential techniques for change within their own practice

Susan Simpson is a Consultant Clinical Psychologist, specialising in the practice and teaching of Schema Therapy for eating disorders with complexity and comorbidity over the past 20 years. She currently works as Team Lead in NHS Forth Valley Eating Disorders Service. She is director of the only ISST-accredited Schema Therapy training program in Scotland and regularly runs Schema Therapy workshops in Scotland and abroad. She is part of an international research group currently investigating the effectiveness of Schema Therapy for eating disorders. She has published several research papers on the schema therapy model applied to a range of clinical populations and has presented her findings at national and international conferences. Susan co-authored the first book on Schema Therapy for Eating Disorders, which was published by Routledge in 2020. A full list of her publications can be found at https://www.researchgate.net/profile/Susan_Simpson/publications

Key References

Arntz, A. (2012). Schema Therapy in Practice: An Introductory Guide to the Mode Approach. Wiley-Blackwell

Simpson, S. & Arntz, A. (2000). Core Principles of Imagery. In G. Heath & H. Startup. Creative Methods in Schema Therapy: Advances and Innovation in Clinical Practice. Routledge.

Simpson, S., & Smith, E. (2020). Schema Therapy for Eating Disorders: Theory and Practice for Individual and Group Settings. Routledge.

Coming soon:

Brockman, Simpson, Hayes, van der Wijngaart, & Smout (2023) Cambridge Guide to Schema Therapy. Cambridge University Press