Integration of Schema Therapy & Positive Psychology
by David Bernstein, Bo Bach, John Louis, and Robert Brockman
Positive Psychology has been defined as the “science of human flourishing, an applied approach to optimal functioning” (Gable & Haidt, 2005). It encompasses factors such as positive mental states and experiences, strengths and values, which enable people, organizations, and societies to thrive. Positive Psychology is having a profound influence on the field of mental health, informing new interventions (e.g., mindfulness meditation, strengths and values finding), and serving as a corrective for psychology’s tradition emphasis on psychopathology. In this symposium, we discuss recent advances in the integration of Schema Therapy and Positive Psychology, including new theoretical models, clinical applications, and empirical research findings. Schema Therapy’s emphasis on promoting core emotional needs, healthy adult functioning (i.e., the Healthy Adult mode), and happiness (i.e., the Happy Child mode), makes it highly compatible with concepts and methods from Positive Psychology.
We cover several recent areas of integration between Positive Psychology and Schema Therapy, including theory and practice: elaborating the model of the Healthy Adult mode; identifying and promoting Positive Schemas; the uses of strengths and values finding methods to promote the Healthy Adult mode; and the application of mindfulness and self-compassion to Schema Therapy. Bo Bach will begin by describing areas of congruity between the model of the Healthy Adult and the DSM-5’s alternative model of personality disorders. David Bernstein will describe a new 4-factor model of the Healthy Adult, and new strengths-based tools for promoting it.
Conceptualizing DSM-5 Section III Personality Functioning from the Perspective of Healthy Adult Functioning
Dr. Bo Sayyad Bach
General Abstract for Presentation 1:
The DSM-5 Alternative Model of Personality Disorders (AMPD) and the new ICD-11 Classification of Personality Disorders rely on core features of personality functioning as essential for assessing and diagnosing personality disturbance on a continuum from healthy functioning to severe impairment. Interestingly, in contrast to previous classification systems, the AMPD model defines impairment of personality functioning based on a definition of healthy personality functioning. The current presentation seeks to clarify the conceptual alignment of Healthy Adult capacities with capacities of Healthy Personality Functioning according to the AMPD and ICD-11 models of Personality Disorders. It is overall concluded that a global dimension of Personality Functioning is largely compatible with the schema therapy concept of Healthy Adult in terms of sense of identity, self-directedness, self-worth, capacity for emotion regulation, capacity for healthy intimacy, capacity for healthy fulfillment of own needs, among others. This conclusion suggests that clinical assessment of Personality Functioning may serve as a transdiagnostic evaluation of impaired or under-developed capacities, comparable to lack of healthy adult capacities, which may inform level of resilience, psychological maturity, therapeutic relationship, and intensity of treatment (e.g., level of limited reparenting).
A New, Integrative Model of the Healthy Adult: Theoretical and Empirical Background and New Strengths-Based Tools
Dr. David Bernstein
General Abstract for Presentation 2:
Recently, Bo Bach and I (Bach & Bernstein, 2019) described areas of congruency between Schema Therapy’s model of the Healthy Adult and the DSM-5’s alternative model of personality disorders, which emphasizes a continuum between healthy and unhealthy personality functioning. Building on that work, I recently introduced a new model of the Healthy Adult, which encompasses 16 positive qualities grouped into four broad factors: Self-directedness, Self-regulation, Connectedness, and Transcendence (Bernstein, 2019). For example, the Self-directness factor is the ability to set and pursue one’s own life course. It includes the specific qualities of Identity, Self- reflection, Self-assertion, Self-confidence, and Imagination. The model of the Healthy Adult is based on the idea that the personality is a dynamic, adaptive system that functions to regulate internal states involving affects and impulses (self-regulation or homeostasis) and also maintains equilibrium with the external environment (Block, 2002). The specific qualities (i.e., strengths) that form the four factors were chosen from a review of empirical research on personal strengths and psychological well-being, including the well-known Values in Action Classification of Strengths (Peterson & Seligman, 2004), and various literature reviews and meta-analyses (e.g., Steel, Schmidt, & Shultz, 2008; Strickhouser, Zell, & Krizan, 2017). I have also developed tools that map onto the four-factor model for assessment and treatment purposes: an adjective checklist (BL48), a self-report questionnaire (BIQ), and a set of cards with cartoon-like images of the 16 specific qualities of the Healthy Adult, similar to the widely used Bernstein iModes. I have integrated these strength-based tools into a new system for working with schema modes and strengths, which uses the visual metaphor of a sailboat to depict a person’s life journey (Alberts, 2018). I hope that this presentation will stimulate collaborative research on this new model of the Healthy Adult and integration of Positive Psychology and Schema Therapy.
Early Adaptive Schemas: Theoretical Model and Empirical Support
Dr. John Louis
General Abstract for Presentation 3:
The positive counterpart of Early Maladaptive Schemas (negative schemas) is termed Early Adaptive Schemas (positive schemas), developed during childhood and adolescence when one’s core emotional needs are adequately met by primary caregivers. Since schemas are defined by distinct themes, a concept now widely accepted within cognitive psychology, it is reasonable to assume that positive and negative schemas are separate constructs. Therefore, a diminution in intensity of a negative schema would not necessarily mean a corresponding increase in a positive one; in other words, people can hold multiple contradictory beliefs about themselves and the world. Strengthening positive constructs, as advocated by positive clinical psychology, has been shown to be as successful at reducing psychopathology as weakening negatives. This is In line with one of the goals of schema therapy which is to not just reduce the strength of negative schemas, but to also increase the healthy adult mode that is believed to be driven by positive schemas. With the identification of these specific types of positive schemas, therapists will be better equipped to understand how best to leverage strengths in a patient working on a particular problem. The understanding of positive schemas’ influence in adaptive functioning will further provide therapists a more holistic overview of a patient. A more balanced focus on both positive and negative schemas will also provide a more affirming tone to a patient which can potentially improve the therapeutic alliance through the process of limited reparenting and lead to better outcomes.
Contextual Schema Therapy: A Guide to Integrating ACT and 3rd Wave Therapy Approaches to Build the Healthy Adult Mode in Schema Therapy
Dr. Robert Brockman
General Abstract for Presentation 4:
The Healthy Adult mode is the backbone of a successful schema therapy treatment. Despite this key role, a detailed description of how the Healthy Adult mode can be explicitly enhanced has been lacking in the schema literature. In this presentation we introduce an approach to developing and strengthening the healthy adult part of the self based on our recent book "Contextual Schema Therapy" (Roediger, Stevens, & Brockman, 2018). First, we introduce empirical evidence from our lab that demonstrates the relevance of ACT and 3rd wave constructs (mindfulness, self-compassion, values) to the healthy adult mode. Next, we introduce an updated two-part definition of the Healthy Adult mode which conceptualizes this mode as a combination of healthy adult self-processing (e.g. awareness, mindfulness) and healthy content (healthy schemas). Finally, we outline how this mode can be explicitly promoted in Schema Treatment drawing on core Acceptance and Commitment Therapy(ACT) and 3rd wave therapy processes including mindfulness, acceptance, values, and self-compassion.
About the Presenters:
Dr. David Bernstein is a Clinical Psychologist (PhD, New York University, 1990) and Associate Professor of Psychology at Maastricht University in the Netherlands, where he has served as Professor of Forensic Psychotherapy (endowed chair, 2010-2018), and Chair of the Section on Forensic Psychology(2010-2015). He is a former President of the Association for Research on Personality Disorders (2001-2005) and Vice-President of the International Society for the Study of Personality Disorders (2003-2007). He was also Vice-President of the International Society of Schema Therapy(2010-2012) and is an Advanced Level Schema Therapist and Schema Therapy Supervisor. He is the author or coauthor of more than 120publications on psychotherapy, personality disorders, forensic psychology, childhood trauma, and addictions. He is the coauthor of Schema Therapy: Distinctive Featureswith Eshkol Rafaeli and Jeffrey Young and the DVD series, Schema Therapy: Working with Modes, with Remco van der Wijngaart.He is also the author of the Childhood Trauma Questionnaire, a reliable and valid self-report questionnaire for child abuse and neglect, used worldwide. He is the creator of the iModes, a cartoon-based system for working with schema modes (www.i-Modes.com), and the founder of SafePath Solutions, a team-based program for adults and youth with personality disorders, aggression, and addiction (www.SafePath-Solutions.com). He was the Principal Investigator on a recently completed randomized clinical trial of Schema Therapy for forensic patients with personality disorders in the Netherlands.
Dr. Bo Bach is advanced-level schema therapist and ISST accredited trainer/supervisor. He is a clinical psychologist and holds a Ph.D. in Psychiatry from the Faculty of Health and Medical Sciences, University of Copenhagen. He works as a part-time clinician and part-time senior research associate at the Center for Personality Disorder Research (CPDR), Psychiatric Hospital in Slagelse, Denmark. Beyond schema therapy, his major interest is classification of personality disorders and its implications for conceptualization, treatment planning, and therapy. Dr. Bach is consultant for ICD-11 and DSM-5.1 personality disorder workgroups, and he is a member of the Hierarchical Taxonomy of Psychopathology (HiTOP) consortium and actively involved in the European Society for the Study of Personality Disorders (ESSPD).
Robert Brockman is a Clinical Psychologist and senior research fellow at the Institute for Positive Psychology and Education,Australian Catholic University. He is also principle Clinical Psychologist atSchema Therapy Sydney, a Sydney based psychology clinic focused on the practice and dissemination of schema therapy.His clinical practice and research has largely focused on the applicability of schema therapy to novel treatment populations (e.g. Eating Disorders, GAD, Psychotic Symptoms), and the integration of 3rd Wave Therapy techniques into Schema Therapy practice
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