Jeffrey Young’s focused therapy is very effective in cases of chronic psychological disorders or when they do not respond to other therapies. This interesting approach integrates the theories of attachment, the currents of Gestalt, constructivism, some elements of psychoanalysis and also the cognitive-behavioral bases themselves.
If there is something that every psychologist knows, there are clinical realities that are very difficult to treat. The causes can be several: the personality of the patient himself, the rate of relapses and even the disorder itself. Let’s think, for example, that conditions such as personality disorders (limit, antisocial, histrionic, etc.) present multiple challenges for every professional.
Moreover, this type of psychological realities benefit greatly from broader approaches, where to combine psychological therapy with social education, workshops and even practices such as Mindfulness, as revealed by a study carried out by the University of Texas and the city of New York.
Integrative approaches work, and the most prominent of these is undoubtedly the therapy centered on schemes, a strategy that supposed in its day an advance with respect to the cognitive treatment of Aaron T. Beck.
“Patients must be willing to give up their maladaptive thinking and behavior styles in order to change. For example, there are people who cling to painful schemes of the past. Thus, by remaining in destructive relationships or by not setting limits in their personal or work lives, they perpetuate the scheme and can not make significant progress in therapy.”
-Jeffrey E. Young-
Scheme-centered therapy, an integrative approach
Psychologist Jeffrey E. Young has spent the last 20 years developing schema-centered therapy based on his experience, and the clinical demands he has had to face every day. Thus, his book Schema therapy, a practitioner’s guide, stands out as an interesting and complete manual. In it, it not only offers the keys for professionals to tackle the most complex personality disorders.
It also serves as a reflection exercise to understand that sometimes it is not good to make exclusive use of a single psychological school. Integrative approaches such as scheme-centered therapy take advantage of more effective resources from other schools for the benefit of the patient. Let’s see, therefore, what it consists of.
What are your goals?
This therapy seeks, as the word itself indicates, identify dysfunctional patterns of the person that push him to think and behave in a way that is problematic and harmful to himself. For this it applies the following guidelines:
- Unlike the cognitive-behavioral school, it does not make use of confrontation or guided discovery. It is based more on emotional and affective therapy.
- Also, it should be noted that more sessions are needed than in other types of therapies to achieve an adequate and strong alliance with the patient.
- They look for dysfunctional schemes that were established in childhood.
- The professional tries to work on the patient’s sense of identity, their capacity for self-control, their emotional communication, their autonomy and their sense of competence.
For which patients is scheme-centered therapy useful?
Scheme-centered therapy is especially effective for all those disorders contained in Axis I of the DSM-V (Diagnostic and Statistical Manual of Mental Disorders). The following clinical conditions are:
- Anxiety disorders.
- Mood disorders.
- Dissociative disorders
Also, Jeffrey Young himself points out the following:
Scheme-centered therapy is beneficial for all those people who can not easily talk about their emotions, thoughts and feelings. Whenever there is a block or a strong negative to it, this approach will be useful.
Patients with existential crises or even with low motivation to the therapy itself will also benefit.
The two pillars of schema-centered therapy
Identify the schemas that explain the behavior
Within cognitive-behavioral psychology, a schema is a pattern that determines the way we think and behave. Many of them lead us to discomfort, suffering and to establish from unhappy affective relationships to lead a self-destructive lifestyle.
Jeffrey Young highlights the importance of understanding what the early life experiences are, and also discovering the patient’s emotional temperament. In this therapy the main focus is on the detection of such schemes and the dynamics that originated them.
The coping style
Starting from how our schemes are, we will apply one way or another of coping with the daily challenges and events that take place in our reality. Dr. Young differentiated four types of problem styles:
- The avoidance, when we just run away and escape our responsibilities.
- Of abandonment. The person experiences sadness, fear and helplessness every time he has to face something, he feels incapable, empty and without any recourse to face life.
- Something very common in the most resistant depressions.
- Counterattack style. In this case the patient usually react with some violence or oversized everything that surrounds him. They are extreme responses to the daily problems of life.
- This type of reality is common in borderline personality disorders.
- The last style is “defectivity”. It is a type of attribution where the patient feels “defective”, perceives that there is something inadequate or failed in him to face his day to day.
Therapy session focused on Jeffrey Young’s schemes
On average, scheme-centered therapy usually lasts about a year. It is a deep and laborious work that requires a work in tune with the patient. Thus, and from this therapeutic connection, we seek to identify those problematic schemes that structure the disorder or the suffering of the person.
Later, and through gestalt techniques, psychoanalysis, cognitive-behavioral therapy and emotional therapy, we try to redirect the person towards the construction of new more valid, effective and above all healthy schemes. It is a type of therapy as interesting as it is useful in many cases.