New directions for cognitive therapy: A schema-focused approach

New directions for cognitive therapy: A schema-focused approach

Ratto, C. L., & Capitano, D. L. (1999). New directions for cognitive therapy: A schema-focused approach. Cognitive and Behavioral Practice, 6(1), 68-73.

Personality disorders are among the most difficult to treat and most frequently encountered problems presented to clinicians. When working with these individuals, it is imperative to have a sound conceptualization and thorough plan for treatment. The conceptualization and treatment plan for a 26-year-old female diagnosed with major depression and borderline personality disorder (BPD) is based on Jeffrey Young's model (1994), schema-focused therapy, an integration of cognitive therapy (CT) with gestalt and object relations techniques. It extends traditional CT developed by Beck, Rush, Shaw, and Emery (1979) by placing greater emphasis on the therapeutic relationship, affective experience, and the linking of early life experiences to present-day problems (Young). This model and treatment approach was developed for character disorders, including BPD, as these individuals often showed a less favorable response to traditional CT. Anna appears to be an appropriate patient for the use of this treatment approach, as she reports long-standing interpersonal problems, severe levels of depression and anxiety, and chronic feelings of emptiness and hopelessness. This paper will outline the schema-focused model of CT and demonstrate how this approach can be applied and tailored to Anna.

USA

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