(Groep-)Schematherapie bij eetstoornissen

Biosketch Dr. Susan Simpson

Dr. Susan Simpson is a Clinical Psychologist who has specialised in Schema Therapy for complex eating disorders over the past 20 years. She currently worksin an NHS inpatient eating disorders unit near Edinburgh. She also runs the only ISST-accredited Schema Therapy training program in Scotland. She regularly runs Schema Therapy workshops through Schema Therapy Scotlandand Schema Therapy Training Australia. She is part of an international research group which is currently investigating the effectiveness of Schema Therapy for eating disorders. She has published several research papers on the schema therapy model applied to a range of clinical populations, and has presented her findings at national and international conferences. She is currently co-authoring the first book on Schema Therapy for Eating Disorders, which will be published by Routledge in 2019.

Background: why use schema therapy for eating disorders?

Eating disorders are amongst the most difficult psychopathologies to treat (Abbate-Daga et al, 2013) with only a proportion of sufferers responding to standard cognitive behavioural therapy (CBT). Indeed, less than half of those with bulimia nervosa (BN) make a full and lasting recovery (Fairburn et al., 1995; Fairburn and Harrison, 2003).  Drop-out (Fassino, Pierò, Tomba, & Abbate-Daga, 2009) and relapse rates are high, and a substantial proportion of individuals experience EDs that are chronic, disabling and highly resistant to treatment (Keller et al, 2006; Steinhausen, 2009).  There is also insufficient support for the effectiveness of CBT for adults with Anorexia Nervosa  (AN), particularly in the severely underweight population (Bulik et al., 2007).  Although the recent transdiagnostic model of eating disorders (Fairburn et al.,2003) has led to some improvement in outcome over the original model, particularly for those with atypical disorders and/or additional psychopathology, approximately 50% of patients remained highly symptomatic at 60-week follow-up (Fairburn et al., 2009). There may be several factors that conspire to make this patient group particularly treatment resistant, most notably the  ingrained and entrenched thinking patterns characteristic of eating disorders (Leung et al., 2000; Mountford and Waller, 2006). In addition, eating disorders are often accompanied by pathology which is difficult to treat, including dissociation, perfectionism, compulsive pathology, and rigid personality traits (Fairburn et al., 2003; Lawson et al., 2007; Waller et al., 2007).

There is a high level of co-morbidity in the eating disorder population (Hudson et al., 2007; Blinder, 2006). The presence of rigid personality features can increase the complexity of eating disorder presentations and has been associated with poor outcome (Thompson-Brenner et al., 2008). Approximately 73% of individuals with EDs experience at least one co-morbid DSM-IV Axis I disorder (particularly mood, anxiety and substance-use disorders) and 68% may also meet DSM-IV criteria for a personality disorder (particularly borderline, dependant, avoidant and obsessive-compulsive personality disorders) (Spindler & Milos, 2007).  In particular, poor treatment outcome and chronicity of eating disorder symptoms has been linked to avoidant-insecure personality pathology (Grilo et al., 2007; Thompson-Brenner et al., 2008).  Eating disorders have also been linked to a range of trauma-related risk factors, including childhood abuse and neglect, which may also be mediated by personality disorder (Brewerton, 2007).

Given the high levels of co-morbidity and prevalence of particular personality traits in this population, it is important to consider the deeper-level belief systems that underlie this pathology. It seems clear that those sufferers with chronic and rigid schema-level beliefs tend not to respond to the standard CBT model and may require treatment which specifically addresses these in a more focused and intensive way (Leung et al., 2000; Waller et al., 2000). The “transdiagnostic model” (Fairburn et al., 2003) begins to address more rigid belief systems, however, this model is also restricted to maintenance factors, with minimal attention paid to early origins of underlying schema-level representations and behaviors. In order to adequately address the features of eating disorders which are not amenable to the here-and-now CBT model, a more sophisticated model is required which specifically addresses the role of early experience in the development of “core” schema-level beliefs, as well as the coping mechanisms which maintain these underlying structures (Waller and Kennerley, 2003).

The schema therapy eating disorder model was developed to specifically address the schema-level beliefs that underpin chronic and persistent pathology in treatment-resistant eating disorders. Schema therapy (ST) was initially developed by Young (1990) as a treatment for chronic and difficult to treat personality pathology, and has been found to be effective as an individual and group treatment for a range of personality and other chronic and characterological disorders (Bamelis et al.,  2014; Giesen-bloo et al., 2006; Nadort et al., 2009; Sempértegui et al, 2013).  It is an integrative approach which draws on CBT, gestalt, psychodynamic and interpersonal therapeutic models, which places significant emphasis on the therapeutic relationship, emotional experience, and early life experiences  (Young, Klosko, & Weishaar, 2003). It emphasises the importance of working on change at four levels: cognitive, behavioural, interpersonal, and experiential.

A preliminary study by investigated the outcome of 20 sessions of group ST specifically adapted for EDs within a sample of 8 participants with chronic and co-morbid EDs. A mean reduction in schema severity of 43% at post-treatment and 59% at 6 month follow-up was achieved by  the 6 treatment completers (2 participants dropped-out mid-treatment) and reliable and clinically significant change in ED severity was achieved by 4 treatment completers (Simpson et al., 2010). These results provide preliminary support for group ST for EDs. Schema therapy has also been trialed with severe Anorexia Nervosa  (Munro et al, 2014), and Binge Eating Disorder (Simpson & Slowey, 2011) with further research underway.

Aims of the workshop

  • Key features of the Schema Therapy Model & rationale for application with eating disorders
  • Strategies for change, with an emphasis on deeper level change with core beliefs/schemas
  • Preliminary evidence for the Schema Therapy model with eating disorders
  • An opportunity to practice using powerful methods of addressing the 'Anorexic Voice'
  • Case study examples to enable participants to consider how they could apply schema change techniques with complex eating disorder clients.
  • Opportunity to think about how you could apply schema change techniques with your own complex eating disorder clients.

 

Program

Day 1:

  • 10.00 – 11.30 Introduction
    • Gaps in Eating Disorder evidence base
    • Comorbidity and complexity in Eating Disorders
    • Rationale for Schema Therapy for Eating Disorders
    • Preliminary evidence of Schema Therapy for Eating Disorders
  • 11.30 – 11.45 Coffee and tea break
  • 11.45 – 13.00
    • Quick review of the basics of schema mode therapy & how it can be applied to eating disorders – with case example
    • Group Exercise: Developing a mode map for conceptualizing Eating Disorders
  • 13.00 – 14.00 Lunchbreak
  • 14.00 – 15.30
    • Schema assessment & education
  • 15.30 – 15.45 Break
  • 15.45 – 18.00
    • Group Exercise (Cognitive): Develop a schema/mode flashcard for Eating Disorders
    • Group Exercise (Experiential): Imagery Rescripting with childhood experiences directly/indirectly linked to development of Eating Disorders

 

Day 2:

  • 09.00 – 12.30 (with a coffee and tea break between 11.30 and 11.45)
    • Group Exercise: Experiential: Chair work
    • Fighting the Inner Critic
    • Bypassing the Overcontroller mode (therapist plays Vulnerable Child)
    • Bypassing the Overcontroller mode (therapist plays Devil’s Advocate)
  • 12.30 – 13.30 Lunch break
  • 13.30 – 14.45
    • Group Exercise: Imagery Rescripting
    • Bypassing the Overcontroller Mode
    • Future-focused imagery
  • 14.45 – 15.00 Break
  • 15.00 – 16.00
    • Common pitfalls and issues
    • Questions & opportunity to discuss cases
Aantal dagen 2
Aantal contacturen 12
Locatie Lestijden (lesdag) Beschikbaarheid
Novotel Maastricht
  • donderdag 31 jan 2019
  • vrijdag 01 feb 2019
meer dan 5 plaatsen
FGzPt12toegekend
VGCt12toegekend
NVvP12toegekend
Schematherapists, clinical psychologists, or health care psychologists working with eating disorders who have at least completed a basic schema therapy course (or those who have comparable knowledge of schematherapy).

Susan Simpson

Dr. Susan Simpson is a Clinical Psychologist who has specialised in Schema Therapy for complex eating disorders over the past 20 years. She currently worksin an NHS inpatient eating disorders unit near Edinburgh. She also runs the only ISST-accredited Schema Therapy training program in Scotland. She regularly runs Schema Therapy workshops through Schema Therapy Scotlandand Schema Therapy Training Australia. She is part of an international research group which is currently investigating the effectiveness of Schema Therapy for eating disorders. She has published several research papers on the schema therapy model applied to a range of clinical populations, and has presented her findings at national and international conferences. She is currently co-authoring the first book on Schema Therapy for Eating Disorders, which will be published by Routledge in 2019.

Na bevestiging van uw aanmelding ontvangt u instructies om de eventueel benodigde literatuur te downloaden.
Informatie

Biosketch Dr. Susan Simpson

Dr. Susan Simpson is a Clinical Psychologist who has specialised in Schema Therapy for complex eating disorders over the past 20 years. She currently worksin an NHS inpatient eating disorders unit near Edinburgh. She also runs the only ISST-accredited Schema Therapy training program in Scotland. She regularly runs Schema Therapy workshops through Schema Therapy Scotlandand Schema Therapy Training Australia. She is part of an international research group which is currently investigating the effectiveness of Schema Therapy for eating disorders. She has published several research papers on the schema therapy model applied to a range of clinical populations, and has presented her findings at national and international conferences. She is currently co-authoring the first book on Schema Therapy for Eating Disorders, which will be published by Routledge in 2019.

Background: why use schema therapy for eating disorders?

Eating disorders are amongst the most difficult psychopathologies to treat (Abbate-Daga et al, 2013) with only a proportion of sufferers responding to standard cognitive behavioural therapy (CBT). Indeed, less than half of those with bulimia nervosa (BN) make a full and lasting recovery (Fairburn et al., 1995; Fairburn and Harrison, 2003).  Drop-out (Fassino, Pierò, Tomba, & Abbate-Daga, 2009) and relapse rates are high, and a substantial proportion of individuals experience EDs that are chronic, disabling and highly resistant to treatment (Keller et al, 2006; Steinhausen, 2009).  There is also insufficient support for the effectiveness of CBT for adults with Anorexia Nervosa  (AN), particularly in the severely underweight population (Bulik et al., 2007).  Although the recent transdiagnostic model of eating disorders (Fairburn et al.,2003) has led to some improvement in outcome over the original model, particularly for those with atypical disorders and/or additional psychopathology, approximately 50% of patients remained highly symptomatic at 60-week follow-up (Fairburn et al., 2009). There may be several factors that conspire to make this patient group particularly treatment resistant, most notably the  ingrained and entrenched thinking patterns characteristic of eating disorders (Leung et al., 2000; Mountford and Waller, 2006). In addition, eating disorders are often accompanied by pathology which is difficult to treat, including dissociation, perfectionism, compulsive pathology, and rigid personality traits (Fairburn et al., 2003; Lawson et al., 2007; Waller et al., 2007).

There is a high level of co-morbidity in the eating disorder population (Hudson et al., 2007; Blinder, 2006). The presence of rigid personality features can increase the complexity of eating disorder presentations and has been associated with poor outcome (Thompson-Brenner et al., 2008). Approximately 73% of individuals with EDs experience at least one co-morbid DSM-IV Axis I disorder (particularly mood, anxiety and substance-use disorders) and 68% may also meet DSM-IV criteria for a personality disorder (particularly borderline, dependant, avoidant and obsessive-compulsive personality disorders) (Spindler & Milos, 2007).  In particular, poor treatment outcome and chronicity of eating disorder symptoms has been linked to avoidant-insecure personality pathology (Grilo et al., 2007; Thompson-Brenner et al., 2008).  Eating disorders have also been linked to a range of trauma-related risk factors, including childhood abuse and neglect, which may also be mediated by personality disorder (Brewerton, 2007).

Given the high levels of co-morbidity and prevalence of particular personality traits in this population, it is important to consider the deeper-level belief systems that underlie this pathology. It seems clear that those sufferers with chronic and rigid schema-level beliefs tend not to respond to the standard CBT model and may require treatment which specifically addresses these in a more focused and intensive way (Leung et al., 2000; Waller et al., 2000). The “transdiagnostic model” (Fairburn et al., 2003) begins to address more rigid belief systems, however, this model is also restricted to maintenance factors, with minimal attention paid to early origins of underlying schema-level representations and behaviors. In order to adequately address the features of eating disorders which are not amenable to the here-and-now CBT model, a more sophisticated model is required which specifically addresses the role of early experience in the development of “core” schema-level beliefs, as well as the coping mechanisms which maintain these underlying structures (Waller and Kennerley, 2003).

The schema therapy eating disorder model was developed to specifically address the schema-level beliefs that underpin chronic and persistent pathology in treatment-resistant eating disorders. Schema therapy (ST) was initially developed by Young (1990) as a treatment for chronic and difficult to treat personality pathology, and has been found to be effective as an individual and group treatment for a range of personality and other chronic and characterological disorders (Bamelis et al.,  2014; Giesen-bloo et al., 2006; Nadort et al., 2009; Sempértegui et al, 2013).  It is an integrative approach which draws on CBT, gestalt, psychodynamic and interpersonal therapeutic models, which places significant emphasis on the therapeutic relationship, emotional experience, and early life experiences  (Young, Klosko, & Weishaar, 2003). It emphasises the importance of working on change at four levels: cognitive, behavioural, interpersonal, and experiential.

A preliminary study by investigated the outcome of 20 sessions of group ST specifically adapted for EDs within a sample of 8 participants with chronic and co-morbid EDs. A mean reduction in schema severity of 43% at post-treatment and 59% at 6 month follow-up was achieved by  the 6 treatment completers (2 participants dropped-out mid-treatment) and reliable and clinically significant change in ED severity was achieved by 4 treatment completers (Simpson et al., 2010). These results provide preliminary support for group ST for EDs. Schema therapy has also been trialed with severe Anorexia Nervosa  (Munro et al, 2014), and Binge Eating Disorder (Simpson & Slowey, 2011) with further research underway.

Aims of the workshop

  • Key features of the Schema Therapy Model & rationale for application with eating disorders
  • Strategies for change, with an emphasis on deeper level change with core beliefs/schemas
  • Preliminary evidence for the Schema Therapy model with eating disorders
  • An opportunity to practice using powerful methods of addressing the 'Anorexic Voice'
  • Case study examples to enable participants to consider how they could apply schema change techniques with complex eating disorder clients.
  • Opportunity to think about how you could apply schema change techniques with your own complex eating disorder clients.

 

Program

Day 1:

  • 10.00 – 11.30 Introduction
    • Gaps in Eating Disorder evidence base
    • Comorbidity and complexity in Eating Disorders
    • Rationale for Schema Therapy for Eating Disorders
    • Preliminary evidence of Schema Therapy for Eating Disorders
  • 11.30 – 11.45 Coffee and tea break
  • 11.45 – 13.00
    • Quick review of the basics of schema mode therapy & how it can be applied to eating disorders – with case example
    • Group Exercise: Developing a mode map for conceptualizing Eating Disorders
  • 13.00 – 14.00 Lunchbreak
  • 14.00 – 15.30
    • Schema assessment & education
  • 15.30 – 15.45 Break
  • 15.45 – 18.00
    • Group Exercise (Cognitive): Develop a schema/mode flashcard for Eating Disorders
    • Group Exercise (Experiential): Imagery Rescripting with childhood experiences directly/indirectly linked to development of Eating Disorders

 

Day 2:

  • 09.00 – 12.30 (with a coffee and tea break between 11.30 and 11.45)
    • Group Exercise: Experiential: Chair work
    • Fighting the Inner Critic
    • Bypassing the Overcontroller mode (therapist plays Vulnerable Child)
    • Bypassing the Overcontroller mode (therapist plays Devil’s Advocate)
  • 12.30 – 13.30 Lunch break
  • 13.30 – 14.45
    • Group Exercise: Imagery Rescripting
    • Bypassing the Overcontroller Mode
    • Future-focused imagery
  • 14.45 – 15.00 Break
  • 15.00 – 16.00
    • Common pitfalls and issues
    • Questions & opportunity to discuss cases
Cursusdagen
Aantal dagen 2
Aantal contacturen 12
Locatie Lestijden (lesdag) Beschikbaarheid
Novotel Maastricht
  • donderdag 31 jan 2019
  • vrijdag 01 feb 2019
meer dan 5 plaatsen
Accreditaties
FGzPt12toegekend
VGCt12toegekend
NVvP12toegekend
Doelgroep
Schematherapists, clinical psychologists, or health care psychologists working with eating disorders who have at least completed a basic schema therapy course (or those who have comparable knowledge of schematherapy).
Docenten

Susan Simpson

Dr. Susan Simpson is a Clinical Psychologist who has specialised in Schema Therapy for complex eating disorders over the past 20 years. She currently worksin an NHS inpatient eating disorders unit near Edinburgh. She also runs the only ISST-accredited Schema Therapy training program in Scotland. She regularly runs Schema Therapy workshops through Schema Therapy Scotlandand Schema Therapy Training Australia. She is part of an international research group which is currently investigating the effectiveness of Schema Therapy for eating disorders. She has published several research papers on the schema therapy model applied to a range of clinical populations, and has presented her findings at national and international conferences. She is currently co-authoring the first book on Schema Therapy for Eating Disorders, which will be published by Routledge in 2019.

Literatuur
Na bevestiging van uw aanmelding ontvangt u instructies om de eventueel benodigde literatuur te downloaden.

495,00

excl. B.T.W.

donderdag 31 jan 2019
vrijdag 01 feb 2019
Novotel Maastricht
495,00