News

UPDATE ON THE GROUP COMMITTEE'S WORK
A committee on Group Schema Therapy was established by the ISST Board of Directors in 2011. I was appointed as chair and over the year we grew to include: Jeff Young, Ida Shaw, George Lockwood, Poul Perris, Neele Reiss, Gerhard Zarbock, Christine Zens, Michiel van Vreeswijk, Eelco Muste, Kerry Beckley, Heather Fretwell, Friederike Vogel, Marco Nill with Hannie van Genderen and Arnoud Arntz as our advisers. We worked this year on a number of group related issues. We formulated recommendations for the ISST Board of Directors regarding a certification in Group ST. Neele led the work on identifying critical components and core interventions of the GST model for BPD. Michiel led the attempt to identify the models of Group ST being used and their stage of development. Gerhard is leading the work on developing the Group STRS we need for research and to institute certification. Our report will go to the board in January and will be posted on the website. We hope to have a meeting of schema therapists interested in Group ST at the ISST congress to further identify the group work being done and to facilitate research and training collaborations.

UPDATE ON THE GST MODEL
I know that I enjoy reading about what other schema therapists around the world are doing as it helps me feel connected to our community. This blog post is intended to fill people in on the development of GST (the abbreviation we are using for the model of group we developed for BPD) and opportunities for collaboration and training with this model. We hope that it is accepted in that spirit and that others working with Group ST will add their information.

This has been an active year for those of us working with the GST model The year began for Ida and I in January with a 2 day workshop at the Schema Therapy Institute NYC, which included Jeff and Wendy as participants along with many of the senior schema therapists connected with the NY and NJ institutes. We are grateful for Jeff’s support and the opportunity to begin the year at the institute where ST began. Needless to say, it was a very interesting and thought provoking workshop and the beginning of discussion about adapting the GST model for other patient populations and settings. A short paper we wrote with Jeff comparing individual ST and GST was also discussed. Poul Perris and Neele Reiss joined us for the training and discussions.

In February we took GST to Australia. Chris Lee was our host for a 3 day workshop in Sydney and 4 days in Perth. The Perth training included the multi-site GST for BPD trial therapists. This is the five country, 14 site trial led by Arnoud and Joan that was planned at the 2008 ISST Conference in Coimbra. There are two sites in Perth. In Sydney we had the pleasure of having a number of experienced group therapists participating. We will be back in November 2012 for a 2 day Introductory Workshop in Brisbane and a 3 day Workshop II in Sydney.

The next few months we worked furiously to finish the manuscript of Group Schema Therapy for Borderline Personality Disorder: A Step by Step treatment Manual and Patient Workbook so that it would be published in time for the ISST Congress. With the help of George Lockwood, Heather Fretwell and Neele Reiss, who read our many “unrelenting standards” driven rewrites, we made the deadline! The treatment manual by Wiley comes out in April 2012. Michiel van Vreeswijk, Jenny Broersen and Marjon Nadort also completed their edited volume Wiley- Blackwell Handbook of Schema Therapy, which has a number of chapters describing approaches to using ST in groups, including our GST model. There is a case study by Neele Reiss, Gitta Jacob and Joan of a BPD patient treated in the Intensive individual plus GST approach used in the Department of Psychiatry and Psychotherapy, University Medical Center Mainz. The Schema Therapy Handbook will also be out by Spring and is already on Amazon.de for pre-publication ordering.

In June we were back in Maastricht for a 3 day workshop and a special 2 day workshop for Creative therapists. It was the second workshop for the Creative therapists and a very productive opportunity for us to again see how specialists in the various experiential therapies work with modes. We took away new ideas for group work. We also held a day-long supervision for therapists participating in the multi-site study. These supervision days occur throughout the year at different locations as they are part of the training plan of the multi-site BPD trial. We think that supervising therapists in a group when group is the subject makes an important training contribution.

In August we gave a one day workshop Klinik für Psychiatrie und Psychotherapie, Lubeck (and saw where marzipan is made!) A landmark event in GST took place at IVAH in Hamburg where we made a DVD set: Group Schema Therapy: An Innovative Approach to Treating Patients with Personality Disorders in Groups (demonstrated with BPD). Gerhard Zarbock was the producer and driving force behind the project with Vivian Rahn and Christine Zens. We had a professional director in Nana Novosad and her crew, which included a make-up artist who put scars and tattoos on our “BPD patient”actors”. Ida and I would not have been able to make the DVD without IVAH’s help and our schema therapist friends who played patients: Gerhard, Christine and Vivian joined by Eva Fassbinder, Niclas Wedemeyer, Friederike Vogel, Brigitte Haaf and Poul Perris. I am happy to announce that the 7 hour DVD set will be available in January. Inquiries can be made to schemadvd@aol.com. Wendy sent the flyer describing the set to the listserv also. The DVD includes a 90 minute typical BPD group session, clips of the core interventions of GST and an interview with Ida and I by Vivian. We hope that it will be helpful for schema therapists interested in how GST works. It was great fun making it with our friends and we really appreciate all the hard work that went into this project and the funds from IVAH that were crucial to the idea being realized. We gave a 2 day Introductory GST workshop at IVAH and a supervision for the multi-site therapists. We will be back at IVAH for a one day Introduction to GST (March 13) and a 3 Day Workshop II (March 14-16).

We had our first London workshop with Chris Hayes and Arnie Reed in September affiliated with their Schema Therapy Workshops. We will be back there soon for a one day Introduction (March 6) and a 3 day GST II workshop (March 7-9) for those who have attended workshop I. The first London workshop included therapists who travelled from Israel, Italy and Greece.

October saw us in Wil, Switzerland with Neele for a second workshop with Christoph Fuhrhans at Schematherapie Ostschweiz Cliena Littenheid. We consulted to his team as they are adapting GST to use with mixed PD groups and plan a pilot study on their inpatient unit. Since they have a certified DBT unit, their studies will allow us to compare the two group approaches directly – an important step in the ST research. We will be back at Clienia Littenheid September 5-9 2012 for an Advanced Workshop.

Another program adapting the GST approach to mixed PD is that of Eelco Muste at de Viersprong. We spent 4 days in October with Eelco and his therapy team – training and planning the integration of GST with the schema based group model Eelco and associates developed and have been using. We think that the combination of the mode and schema focus is important for broadening GST beyond BPD. We realized that when we tested GST on severe BPD patients we were also treating their numerous Axis I and Axis II symptoms. This suggests to us that GST is a good fit for some other PDs particularly those frequently comorbid with BPD and some axis I disorders like Eating disorders and PTSD, with some adaptation for level of emotional awareness. While in Halsteren we also gave a supervision day for the multi-site BPD trial.

Each visit added something to the original GST model for BPD. In NYC with Jeff we explored adapting GST to treat healthier patients. With Gerhard and Christine we further developed our thinking on trauma work in GST. With Chris and Arnie we had the opportunity again to work with therapists from forensic settings and look at the adaptations of GST that setting requires. With Christoph and Neele we explored GST applications for Cluster C and Eating disorder patients. With Eelco we did the same, and we were reminded of the role of schemas in group work and the need to make it more explicit in GST. With the creative therapists in Maastricht and de Viersprong, Ida was particularly happy to add some new experiential techniques to GST. We discussed the need to have psychotherapists and creative therapists in the same workshop, since they are likely to constitute the group therapist pair in most clinical settings. This pairing could solve the problem that we are hearing about as we travel - of sites not being able to have two psychotherapists in the same group. We were reminded of how ideal it can be to have a psychotherapist by training paired with a creative therapist. That is how Ida and I began 25 years ago – combining our different foundations and interventions to have a complete approach that like individual ST integrates experiential work with cognitive and behavioral change.

Schema Therapists who collaborate with us have also taken GST to additional meetings and countries. Heather Fretwell gave a presentation at the American Psychiatric Association meeting in Hawaii this year and with Neele Reiss gave a GST workshop at EABCT in Reykjavik, Iceland. Neele with Arnoud chaired a symposium on GST at that meeting. Neele has been busy presenting papers and giving workshops on GST with Friederike Vogel in Germany and Switzerland. Together with Marco Nill and Brigitte Haaf, they established IPSTI-Mainz and were certified as an ISST Training center. They are initiating their training program in 2012 and plan to have GST as one of their areas of specialty. Heather and Neele accomplished having a workshop on GST accepted for the American Psychiatric Association annual meeting in Philadelphia, 2012. Heather makes regular presentations in Indiana on GST and the BASE group program she directs at Midtown CMHC, which has an enrollment of 100 patients with BPD. She is adapting GST for patients with severe dissociative disorders with Ida and one of her psychiatric residents in training. A pilot of this program is about to begin and will hopefully be presented at the May congress.

Ida and I are happy to announce that this year we joined George Lockwood to become the Indianapolis Center of the Schema Therapy Institute Midwest (STIM) founded by George with STIM- Kalamazoo. We gave a one day workshop in May for the psychology department of Indiana University-Purdue University, Indianapolis IUPUI) and a summer course for clinical psychology graduate students at the University of Indianapolis. We were invited to do this university training because ST has been acknowledged as having a “moderate evidence base” by the American Psychological Association, Clinical psychology division. We will begin to provide training through the Indianapolis Center in June 14-16, 2012. We are joined also by Heather Fretwell and the Center for BPD Treatment & Research- Indiana University School of Medicine and Midtown Community Mental Health Center as partners in this training plan. Feel free to contact us at STIM-Indpls@sbcglobal.net or check our website for more information.

Our plan is to continue to provide GST training in the US and at key collaborating ST institutes in Europe and Australia, which are also committed to GST training and research. To this end, in collaboration with Neele, Gerhard, Christine, and Poul, we developed an organized curriculum for GST training and supervision. This curriculum is currently being offered in Hamburg at IVAH, London with Schema Therapy Workshops, Switzerland with Schematherapie Ostschweiz at the Cliena Littenheid and in Australia (Sydney & Brisbane) with Chris Lee. Plans are being made for 2012 workshops in Maastricht, Mainz at IPSTI-Mainz and in Stockholm at the Swedish Institute for CBT & Schema Therapy. We hope to be able to offer GST training twice a year at these institutes. The GST curriculum and training schedule are on our website http://www.BPD-home-BASE.org

We love the opportunity to interact with schema therapists all over the world and to continue learning and improving the GST model. The multi-site trial sites in the Netherlands and Germany are well underway and Australia has begun. In the US we are still fighting to secure funds, which feels like an uphill battle with the National Institute of Mental Health. As everywhere, funds for research and treatment are shrinking in the US. On a positive note, Ida has been greatly enjoying supervising the GST work of the multi-site therapists. We also offer skype supervision for therapists outside of the trial. A number of new collaborations for research and treatment manuals came out of our travels. In addition, with the Group ST Committee we have planned some interesting submissions on Group ST for the 2012 ISST Conference. We will submit proposals for symposia the new applications of our GST model and an overview of the various models of Group ST. Ida is organizing a symposium on Creative Therapy and GST. We are happy to have been invited to present a ½ day pre-congress workshop on Limited reparenting in GST on May 17th.

We welcome your comments on what we have written here and invite you to add information on other Group ST activities.

Happy Holidays to all of you and see you hopefully in New York!

Joan Farrell & Ida Shaw

Online Paper: Roediger, E. (2012). "Basics of a dimensional and dynamic Mode Model" (see attachment below)

Paper: Van Eeghem, H. (2011). "Als ik nee zeg, voel ik me niet meer schuldig – schemagerichte assertiviteitstraining." Directieve therapie, 31, 2, 131-152.

Paper: P.Mauchanda, K.Lachenal-Chevalletb, J.Cottrauxc (2011).
"Validation empirique du questionnaire abrégédes schémas de Young(YSQ-S2)sur une population de patients présentant un troubl de la personnalité borderline et de sujets témoins. (Empirical validation of the Young Schema Questionnaire-Short Form(YSQ-S2) in borderline personality disorder and control subjects". L’Encéphale 37, 138—143.
Disponible enligne sur www.sciencedirect.com
journal homepage:www.em-consulte.com/produit/ENCEP
PSYCHOPATHOLOGIE

Book: Firouzeh Mehran (2011). “Traitement du trouble de la personnalité borderline" Thérapie cognitive émotionnelle,(second edition), Elsevier- Masson, Paris.

Book: Jean Cottraux: (2011)."Choisir une psychothérapie efficace".(published by Odile Jacob).

Book: Jean Cottraux: (2010)."A chacun sa créativité" - an examination showing that CBT and ST can be integrated easily into the Muslim world (published by Odile Jacob). Translated into Italian (2011)."Creative mente".

Book: Eshkol Rafaeli, David P. Bernstein, & Jeffrey Young (2010) "Schema Therapy: Distinctive Features".
(http://www.routledge.com/books/details/9780415462983/)

Paper: Susan G. Simpson, Emma Morrow, Michiel van Vreeswijk and Caroline Reid. (2010). "Group schema therapy for eating disorders: a pilot study."
(http://www.frontiersin.org/Journal/Abstract.aspx?ART_DOI=10.3389/fpsyg.2...).

Unpublished paper: Chiara DiFrancesco.(2010)"ST with couples"
(http://www.wisconsinfamily.org/pdf/Couples-and-Marriages.pdf)

Paper: Calzoni, R., Sanza, N. (2010) Schema Therapy: un modello di terapia integrato
efficace per i disturbi di personalità, Psicologia Psicoterapia e Salute,16,225-287.

Book chapter: Beckley, Kerry. (2010). Team Dynamics: A schema focused approach. In P. Willmot & N. Gordon (eds.) Working Positively with Personality Disorder. Chichester: Wiley Blackwell and Sons. pp 172-187.

I am pleased to announce the authorization by the ISST board of an official work group on developing Group Schema Therapy (GST).

The goals of the work group are:
1. To refine, and possibly expand, the GST model for a range of Axis II and I disorders. This would involve incorporating any others in the ISST working on group ST that have an evidence base
2. to develop adherence and competency scales for rating therapists conducting groups,
3. to explore and reach consensus within ISST about the best way to integrate GST certification into the current certification process.
4. if there is a consensus about GST certification, to identify the minimum criteria for training in GST and to explore how to integrate GST into existing training programs

The beginning ISST work group consists of those of us who have been working for the last two years on the treatment protocol for the collaborative multi-site BPD RCT now underway, and others who have expressed strong interest in GST. We have been discussing the group model and issues of training and certification with Jeff Young, so that we remain consistent with ST, and are very pleased that he has agreed to be part of the work group. We are also happy to have Arnoud Arntz as our research adviser and Hannie van Genderen as our adviser on training and certification issues.

ISST Work Group on Group Schema Therapy
USA: Joan Farrell, Chair
Ida Shaw
Jeff Young
Heather Fretwell
George Lockwood, board liaison
Sweden: Poul Perris
Germany: Neele Reiss
Marco Nil
Gerhard Zarbock
NL: Michiel van Vreeswijk
Hannie van Genderen, adviser on training & certification
Arnoud Arntz, research adviser
Switzerland: Christoph Fuhrhans

We welcome everyone's input on these issues. Questions and input can be directed to me at ijinindy@sbcglobal.net

Best wishes,
Joan

Joan Farrell, Ph.D.
ISST Certified Schema Therapist
Training Director, Center for BPD Treatment & Research, Indiana University School of Medicine and Midtown Mental Health Center
Asst. Professor of Clinical Psychology, IU School of Medicine
BASE Consulting Group, LLP
Indianapolis Center of the Institute for Schema Therapy Midwest