Emotion-focused techniques in schema therapy and the role of exposure techniques

Abstract

During the last decade, Schema Therapy (ST), a recent CBT development mainly for the treatment of personality disorders (Arntz & van Genderen 2009. Schema therapy for borderline personality disorder. Sussex: Wiley; Young, Klosko, & Weishaar 2003. Schema therapy: A practioner`s guide. New York: Guilford), has become increasingly popular. ST integrates traditional CBT with elements of psychodynamic therapy, experiential therapies, and humanistic therapy. Emotion-focused interventions are extensively used, and systematic emotional work is central to this approach. However, different from standard CBT, ST does not mainly use exposure techniques aiming at habituation and extinction. Instead, the main focus is on changing the implicit and explicit meaning of emotional triggers through emotional restructuring mostly by means of imagery exercises, “chair work,” or historical role plays. This chapter provides, first, a brief overview of the ST approach. Secondly, the model of emotional work in ST is explained. Finally, studies investigating both the effectiveness of ST and emotion-focused interventions (i.e., therapeutic techniques aiming at a direct change of problematic emotions) as used in ST are summarized and open questions are discussed.