"therapist interventions and more changes within schema therapy sessions for avoidant personality disorders"
hot topic by ofer peled & eshkol rafaeli
This study is the first to use segment-by-segment microanalysis of schema therapy sessions with APD clients to reveal the links among therapist interventions and clients' mode changes. Sixty randomly sampled sessions were coded on every 5-minute segment, by 2 newly developed rating scales for therapist interventions and client modes. Among the key findings: a good therapist stance preceded decreases in the avoidant/detached mode and increases in the healthy adult mode; good emotion-focused interventions preceded decreases in the overcompensating mode; good relational interventions preceded decreases in the over-compensating mode; good cognitive interventions preceded increases in the vulnerable child mode and the dysfunctional parent mode; Finally, good behavioral pattern braking interventions preceded decreases in the dysfunctional parent mode. In summary, it seems that a therapeutic stance which is compassionate, genuine and flexible helps clients become less detached and avoidant and fosters their mature and balanced behaviors; experiential techniques and relational interventions diminish clients' arrogant over-controlling behaviors; cognitive interventions raise clients' vulnerability as well as their self-critical tendencies; on the other hand, behavioral pattern-breaking interventions reduce clients' self-critical tendencies and may pave the way toward greater self-compassion and healthier coping with triggering situations. Further micro-analytic studies of therapy processes are needed to guide therapists in choosing effective interventions when facing distinct moments in their interaction with their clients.
Eshkol Rafaeli, Bar Ilan University, Ramat Gan, Israel
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