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Schema therapy for borderline personality disorder: Patients' and therapists' perceptions

Tan, Yeow May (2015) Schema therapy for borderline personality disorder: Patients' and therapists' perceptions. Professional Doctorate thesis, Murdoch University.

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Schema therapy (ST) is effective in promoting clinically meaningful gains that ameliorate symptomatology for borderline personality disorder (BPD). However very little is known about how the therapy is experienced by patients or therapists including which elements of ST are effective from patients’ and therapists’ perspectives. The aim of this study is to explore BPD patients’ experiences of receiving ST and therapists’ experiences in delivering ST. Qualitative data were collected through semi-structured interviews with 11 patients who had a primary diagnosis of BPD and eight trained schema therapists. Interview data were analysed following the procedures of inductive, content analysis. Patients’ broad perceptions of ST included the experience of greater self-understanding, better awareness of their own emotional processes and better connections with their emotions. While the process of ST was perceived as emotionally confronting, patient narratives highlighted that this was perceived as necessary. Therapists generally regarded their experience as rewarding based on patients’ positive responses to treatment, and discussed changes made in their professional (e.g. incorporating more ST in their therapy) and personal (e.g. increased self-awareness) lives. However therapists also described being confronted with novel challenging situations despite having years of therapy experience. Patients and therapists were concordant on several therapeutic components of ST (e.g. ST provides insight, benefits of experiential techniques) and some therapeutic group factors not specific to ST (e.g. sense of connection among group members). On the other hand there exists a possible interplay between level of patient dysfunction within the group and therapists’ ability to manage group conflict. Recommendations for more effective implementation of schema therapy are discussed as well as issues for other specialist treatment approaches to BPD particularly concerning termination of therapy and definitions of recovery. Finally implications of the findings are discussed in terms of assessing the suitability of patients for group ST.

Publication Type: Thesis (Professional Doctorate)
Murdoch Affiliation: School of Psychology and Exercise Science
Supervisor: Lee, Chris and Arntz, Arnoud
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