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Schema Therapy with Adolescents: Creative techniques within a highly restrictive environment

by Suzanna Ritter


This case presentation highlights the complexities of working with adolescents in secure services, where the environment is highly restrictive and requires adaptations to modality of treatment. This is presented in the context of working with an adolescent client, currently sectioned under the mental health act for treatment in a low secure child and adolescent mental health facility in the UK. The clients primary presenting difficulties include dietary restriction, emotional dysregulation, self-harm, aggression towards others and periods of dissociation.

The case study will highlight environmental obstacles faced when working in a highly restrictive environment, along with treatment adaptations made. The case presentation will also discuss progress to date, including a reflection on the adaptations made to ways of working with modes in a restrictive environment.

About the Presenter:

Suzanna Ritter

Dr. Suzannah Ritter (DForenPsy) is a Forensic Psychologist and Schema Therapist currently working for a private CAMHS provider in the UK. She is trained in CBT, DBT, and EMDR, and is a Certified Schema Therapist and member of the International Society of Schema Therapy. Suzannah began her forensic training at the University of Surrey, before completing her Doctorate studies at the University of Nottingham. Suzannah has published research in the area of forensic psychology and has previous experience of working in HM prison service, youth offending service and secure units. She has also worked in adult services, including low secure, personality disorder, psychiatric intensive care and rehabilitation. Suzannah is currently head of psychology in a private low secure child and adolescent mental health inpatient unit, and has experience of with working with complex presentations, personality disorder, PTSD, eating disorders, forensic presentations, trauma and psychosis. As well as working with complex clients, she also provides supervision and training for other clinical staff. Suzannah began training in Schema Therapy in 2015, and has been utilizing this approach to working with clients since this time. She now works with adolescents aged 13-18, who are detained under the Mental Health Act in a low secure hospital, where she has continued to deliver Schema Therapy on an individual basis.

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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