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Borderlinecliënten behandelen met schematherapie is leuk ...Samenvatting
Maakt schematherapie het behandelen van een cliënt met een borderlinepersoonlijkheidsstoornis echt leuker? Uit onderzoek (Giesen-Bloo et al., 2006) blijkt in ieder geval wel dat drie jaar intensieve schematherapie in 45% van de gevallen leidt tot volledig herstel en in nog eens 20% tot aanzienlijke verbetering. Na vier jaar is het percentage herstelde cliënten gestegen tot 52%. Dat geldt zowel voor lichtere gevallen als voor cliënten met ernstige symptomen. De therapie verreist een speciale hantering van de therapeutische relatie (limited reparenting) en een afwisseling van experiëntiële, cognitieve en gedragsmatige technieken. In dit artikel wordt schematherapie in het algemeen en de limited reparenting en de experiëntiële technieken in het bijzonder, toegelicht aan de hand van een casus. De vragen over de meest controversiële elementen in de therapie, zoals het modusmodel, limited reparenting en experiëntiële technieken worden in de discussie besproken. Geconcludeerd kan worden dat schematherapie niet alleen werkzaam is, maar gaandeweg de behandeling voor zowel cliënten als therapeuten ook steeds leuker wordt.
Summary
Does Schema Therapy really increase the fun of treating patients with a Borderline Personality Disorder? Research (Giesen-Bloo et al., 2006) has demonstrated that three years of Schema Therapy leads in 45% of the cases to recovery from the Borderline Personality Disorder, and in another 20% of the cases to significant improvement. After four years the proportion of recovered patients had increased to 52%. This held both for the more and the less severe patients.
The treatment requires a special way of dealing with the therapeutic relationship (limited reparenting) and a mixture of experiential-, cognitive- and behavioural techniques. This paper offers a general introduction to Schema Therapy and specifically elucidates limited reparenting and experiential techniques with the help of a case example. Issues related to the most controversial elements of Schema Therapy, such as the schema mode model, limited reparenting and the experiential techniques are reviewed in the discussion. It is concluded that Schema Therapy is not only effective, but also increases the fun of the treatment both for patients and therapists.
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