PhD defence Michiel Floris van Vreeswijk

Keywords: Group Schema Therapy, Personality Disorders, Patient Satisfaction, Brief Schema Therapy

"Monkey Rock and Stepping Stones to Change: Schemas and Modes in Brief Group Schema Therapy"

This thesis is about brief group schema therapy for people with personality disorders and long-standing problems. It focuses on three questions: what therapists need (solid training and supervision), how patients experience treatment, and what predicts who benefits most. In both out patient and day-programme settings, the brief format is feasible and well liked. Symptoms clearly improve, and entrenched thinking and behaviour patterns (“schemas” and “modes”) shift along side these changes; more than half of patients show meaningful improvement. People who start off more severely, or who have a profile with more outward-facing reactions(quicker to anger or impulsive),often improve even more. It works better to look at the overall pattern rather than single test scores; strong worries about health and safety and an inner ‘vulnerable child’ state(feeling small, scared and alone) are especially helpful in guiding what  someone needs. Bottom line: well-trained co-therapists and care matched to the whole profile make brief group schema therapy both effective and efficient.

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