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ST of Children with Conduct Disorders, Aggressive & Self-Harming Behaviors

by Maria Galimzyanova & Elena Romanova 


Julia Laanemets Individual ST treatment of a 10 year old boy with conduct disorders at school. A case study illustrates individual ST treatment of a boy with conduct disorders. Therapy was recommended to the boy by the school authorities, as he had gained a reputation of a problematic student and the mother was advised to transfer him to a specialized school for children with educational and social disabilities. After the parent’s divorce father has moved to another country, maintaining a very irregular contact with his child, that, in it’s turn, contributed to the development of a Schema of Abandonment/Instability and a subsequent aggressive behavior at school. During 15 individual ST sessions, storytelling and play-therapy techniques were used. Mode work with figures (making an “Inner-Mode-Team”) helped to externalize his aggression towards his classmates (Angry and Bully and Attack modes), understand the origins of his academic problems (strong Impulsive Mode). As it was hard for him to admit and accept his Vulnerable Mode, it was rea treated by the therapeutic storytelling techniques. Mode-work helped him to become aware of the mode triggers and understand his role in producing conflicts. His mother attended schema-coaching sessions. ST work helped her to learn to meet her son's needs. Also observation work was carried out at school and a round table for teachers was held. Teachers and school staff also made several changes in their work to help the child to socialize better. As a result of a 0,5 year ST work, situation at school was significantly stabilized, the boy gained a new friend, his school performance became better. The boy obtained the skills of understanding and expressing his emotions, venting his tension and anger, and using relaxation techniques Natalia Shilnikova Individual and family ST work with a boy of 11 years old with impulsive and aggressive behavior at school A case study illustrates individual and family ST treatment of a boy with impulsive and aggressive behavior at school. Boy’s Defectiveness/ Shame and Emotional Deprivation Schemas were the main sources of the extremely destructive Angry Protector Mode that contributed to his aggressive behavior at school. The boy himself was bullied at school – classmates provoked him due to his high impulsivity and extreme reactions to criticizm. Starting from the early age, he suffered from his mother’s neglect, (as after his birth his mother paid maximum attention to his twin brother and ignored and neglected the client’s needs). Father left the family and it worsened the situation. Mother’s schemas of Unrelenting Standards and Emotional Deprivation were aggravated and it caused her severe asthenic depression. During 25 sessions of individual ST play therapy and behavioral pattern-breaking was used. Initially the boy learned to define the feelings, connect feelings to behavior, defined and named his feelings and modes, found a toy for each mode. He united his feelings and schema modes, creating a "City of feelings". It became visible, that the rapid flipping to the "Helpless" mode and a lack of support from the Wise Mode activated a "Furious" and "Revenge" Modes. Also a strong Punitive Critic Mode got triggered and it reinforced the above mentioned modes. Mode role-plays, “Mode conferences”and Mode dialogues were held in individual ST. The boy’s mother was engaged in schema coaching and in the play therapy process. Schema Therapy board game "Journey through the Modes Valley" was used with the whole family during the ST family sessions. As a result, his attitude to classmates and behavior at school has changed significantly This case study illustrates the effectiveness of schema therapy, schema coaching and family work in treatment of destructive aggressive behavior.
Uliana Rozova
Individual and group schematherapy with a12-year old boy with conduct disorders and self-harming behavior. A case study illustrates individual and group Schema Therapy of a boy with conduct disorders and sеда-harming behavior. His parents conflicts, subsequent divorce and mother's rejection contributed to the acquisition of a strong Abandonment / Instability schema. The relations between his mother and his father were explosive and violent and the boy suffered between two confronting sides. As the boy was the eldest of three boys in the family, his mother wanted him to take a father’s role. His mother suffered from borderline personality disorder that made her unstable, unpredictable and aggressive. These factors caused boy’s self -harming behavior. Fleece stripe was used as a symbol of connection and helped to bypass strong detachment. Mode work with figurines helped the boy to release his emotions, learn to express them safely. The work with resources included making a “Treasure box” containing symbols of memories, boy’s good qualities, loving people and self-help techniques to practice in situations when schemas are triggered. Inner house and role play helped the boy to analyze his feelings, his behavior. Within 35 individual and 10 group sessions the boy became aware of his feelings and schema triggers, started to improve his relationship with his mother, significantly developed his Wise Mode and learned to take care of his Vulnerable Child Mode. Maria Galimzyanova and Elena Romanova
Individual and Group Schema therapy and Schema-coaching of a mother of four children with Borderline Personality Disorder. In continuation of a previous case, this case study illustrates individual and Group Schema Therapy and Schema-coaching of a boy’s mother with a borderline personality disorder. Her strong Abandonment / Instability schema was acquired in childhood as her parents had serious conflicts and fights. Her mother had a few suicide attempts and father was alcoholic. She came to therapy having a conflictual and violent relationship with her husband. Pushing him away she felt vulnerable and lonely and staying together they both were explosive. Relationships with children disappointed her and she felt uncapable to improve them. Sometimes she felt confident and happy, but a slight situation could cause strong aggression or depression. Limited reparenting was essential. It helped her to feel more stable and calm. A key point in treatment was imagery rescripting of the childhood memories connected with the parents. During 3 years of individual and group ST treatment she learned to meet her own needs, accept and comfort her Vulnerable Child Mode and gained enough confidence that could divorce her husband. She started to sing and became a professional singer that raised her self-confidence. She provided therapy for all 4 children and started to attend Schema-coaching sessions to improve relationship with the children. Schema-coaching helped the client to understand her children's feelings and her own feelings towards them, decrease the level of parentification and become more positive.

Expected Points of Discussion: 
1. Developmental origins of conduct disorders, agressive and self-harm behavior
2. Schemas and modes that usually contribute to conduct disorders, agressive and self-harming behavior
3. Problems and obstacles in treatment of children with conduct disorders, agressive and self-harming behavior
4. Most helpful ST-CA interventions for children with conduct disorders, aggressive and self-harming behavior
5. Main objectives of Schema coaching and ST with parents of children with conduct disorders, aggressive and self harming behavior

Discussant 1
Name: Julia Laanemets

Discussant 2
Name: Natalia Shilnikova

ISST Certification Level? (Standard, Advanced) Standard
ISST Certification Area? (individuals, couples, group, children & adolescents, forensic, auxiliary) Children and adolescents

Discussant 3
Name: Uliana Rozova

This Skill Class is intended for: 


About the Presenters:

Maria Galimzyanova

Maria Galimzyanova, Ph. D., advanced trainer-supervisor in Individual, Group and Child-Adolescent Schema Therapy. Being an expert and an author in the area of Child-Adolescent ST, she has developed a group model for children and adolescents, consistent with the GSTconcept by J. Farrell and I. Shaw and a ST-CA by C. Loose, G. Zarbock and P. Graaf. As a professor of St-Petersburg State University and St-Petersburg Institute of Schema therapy, she lectures onschema therapy both nationally and internationally to students and professionals. She has been treating patients for more then 19 years and her private practice is primarily focused on treating children, adolescents and their parents.

Elena Romanova

Elena Romanova has been treating patients, training professionals and supervising psychotherapists for more than 28 years. She has also been employing a wide range of experiential interventions from sensory motor therapy to fairy-tales and life rescripting with a strong grounding in developmental psychology and consistency with the Schema Therapy model. Dr. Romanova is an Advanced Schema Therapist and Supervisor Trainer in Individual, Group Child and Adolescent Schema Therapy and directs a Schema Therapy Institute of St -Petersburg in Russia. She has presented advanced Therapy training at EABCT, ISST conferences and Summer Schools as well as in training programs in 10 countries. 

Why Schema Therapy?

Schema therapy has been extensively researched to effectively treat a wide variety of typically treatment resistant conditions, including Borderline Personality Disorder and Narcissistic Personality Disorder. Read our summary of the latest research comparing the dramatic results of schema therapy compared to other standard models of psychotherapy.

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