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Hot Topics: Session 4

The Need for the dreaded: An investigation of the therapeutic alliance in schema therapy for patients with avoidant personality disorder

by Marie Hau


This master thesis investigates the therapeutic relationship within the framework of schema therapy with regards to what comprises an effective therapeutic alliance between therapist and patient in relation to avoidant personality disorder. Schema therapy highlights an ability to intervene within the therapeutic relationship between therapist and patient. This makes it an interesting approach to consider for patients with avoidant personality disorder as they are characterized by the fear of engaging in relationships.

My thesis is seemingly the first investigation that directly accounts for how the therapeutic relationship in schema therapy can be comprehended in relation to the impairments faced by patients with avoidant personality disorder.

The applied method of my thesis revolves around a systematic research for relevant literature and resulted in two independent literary reviews about respectively avoidant personality disorder and schema therapy with therapeutic alliance as the common denominator.

A thematic analysis of the findings from the first literary review yielded empiric evidence for various impairments in avoidant personality disorder and points to several considerations in order to establish and maintain a therapeutic alliance. The second literary review brings about a consistent theoretical model for understanding avoidant personality disorder as it appears within schema therapy. Furthermore, the distinctive elements which compose the therapeutic relationship in schema therapy is considered in relation to treatment outcome and the theoretical concept of therapeutic alliance.

The present thesis argues that the effect of the therapeutic relationship in schema therapy is brought about by the advantageous framework that creates an applied way for therapist to connect and interact with patients diagnosed with avoidant personality disorder. Finally, the thesis provides recommendations for adapting psychotherapy to the specific difficulties of patients with avoidant personality disorders with careful consideration as to assisting these patients with the need to confront the fear that defines their disorder.

About the Presenter:

Marie Hau

As a fairly new psychologist, I am happy to concentrate my work towards the subject that has always had my attention within the field of psychology: psychotherapy. As a psychologist, I practice therapy for primarily adults and adolescents within a cognitive behavioral therapy framework. My main interests revolve around psychopathology and personality problems.

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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