Schema Therapy for Pervasive and Chronic Life Problems: A Hermeneutic Single-Case Efficacy Design Study

Schema Therapy for Pervasive and Chronic Life Problems: A Hermeneutic Single-Case Efficacy Design Study Bu yazının fikri hakları Psk. Dr. Ece Ataman Temizel yazarına aittir. Ankara Psikolog

İ. Volkan Gülüm, Gonca Soygüt & Ece Ataman

Abstract

This study examines Schema Therapy (ST) within a framework inspired by the adjudicated hermeneutic single-case efficacy design. The client was a nineteen-year-old female college student, suffering from chronic life problems and cluster of related issues. She was evaluated as using quantitative and qualitative data. Based on these data, affirmative and sceptical arguments were developed about whether the observed change could be attributed to ST, or not. Three adjudicators concluded that the client substantially progressed over the course of therapy. Both the client and the adjudicators emphasized that the experiential techniques and therapeutic relationship, which are prominent features of ST, were effective in her treatment process. Bu yazının fikri hakları Psk. Dr. Ece Ataman Temizel yazarına aittir. Ankara Psikolog

Keywords: Case study research, qualitative research methods, hermeneutic single-case efficacy design, schema therapy, efficacy

Introduction

Schema Therapy (ST) is an integrative psychotherapy approach founded by Young (1990) and expanded in Young, Klosko & Weishaar (2003) to treat clients with chronic, pervasive, and resistant psychological problems. ST includes some important aspects of cognitive therapy, attachment and object relations theories, along with Gestalt and experiential therapies (Young, 1990). Although ST is an integrative psychotherapy approach, and sometimes considered in the scope of cognitive-behavioural therapy, it has prominent characteristics, such as (a) it puts substantial emphasis on the aetiology of the problems, (b) in the therapist-client relationship it highlights corrective emotional experience and empathetic confrontation, and (c) it suggests experiential techniques widely (Young et al., 2003; Weertman, 2012). Formulating specific modes and providing a needs-oriented, “limited re-parenting” relationship to address the client’s individual problems or schemas are also distinctive features of the model. Bu yazının fikri hakları Psk. Dr. Ece Ataman Temizel yazarına aittir. Ankara Psikolog

Schema Therapy focuses on early maladaptive schemas (EMSs) caused by unmet core emotional needs and toxic experiences during childhood and adolescent life. Originally, these EMSs were mainly considered to relate to Axis II disorders, but recently they have become recognized risk factors for all kinds of psychological problems (Green et al., 2010). For instance, as reviewed in Hawke & Provencher (2011), mood and anxiety disorders correlate highly with EMSs. Along with the schemas, the mode concept was also established and broadened to cover a wide range of psychological disorders (Young et al., 2003; Lobbestael et al., 2007). Recently, there have been efforts to conceptualize eating disorders and obsessive compulsive disorders within the frame of the schema mode model (Gross, Stelzer & Jacob, 2012). In conclusion, in parallel with recent theoretical and practical contributions, ST is considered an appropriate approach for mild-to-severe problems and short-to-long-term interventions (Arntz & Jacob, 2013).

Given that Schema Therapy is a relatively newly developed model, studies focusing on its efficacy and effectiveness are still at the initial stage. However, there are some promising findings that show ST is an efficacious and cost-effective treatment approach for personality and mood disorders (Giesen-Bloo et al., 2006; Baumelis et al., 2014; Carter et al., 2013; Gude & Hoffart, 2008).