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Schema Therapy-Inspired Protocol for Anxiety: An Evidence-Based Approach (T10)

by Offer Maurer & Eshkol Rafaeli


The schema mode model (Rafaeli, Bernstein, & Young, 2011; Young, Klosko & Weishaar, 2003), originally developed for the treatment of personality disorders, is gradually proving itself to be distinctly suited to address the vexing problems faced by individuals who suffer from various Axis-I disorders as well. Disorders such as depression, social anxiety, eating disorders, PTSD, and OCD are often highly comorbid with each other and with personality disorders, a fact which helps explain why even state-of-the-art methods for their treatment often have less-than-desirable effects. Indeed, the complexity of problems, the interpersonal dysfunction that often accompanies them, and the difficulty forming trusting and collaborative bonds with the therapist often leave individuals with primary Axis-I disorders in great distress.

The schema therapy model, and particularly its recent developments which emphasize the role of modes, explicitly addresses schemas (and associated core beliefs), emotions, behaviors, and interpersonal difficulties, with the therapeutic relationship as the primary vehicle for change, make it highly suitable to target the entrenched belief systems and high levels of avoidance characteristic of both personality disorders and many axis-I disorders.

In this pre-conference workshop, we will present an evidence-based intervention for anxiety, inspired by schema therapy and incorporating both imagery methods and cognitive behavioral techniques into a unified 6-session protocol. This protocol, developed at Bar-Ilan University (Prinz, Lutz, Bar-Kalifa & Rafaeli, 2016) has been successfully tested in a recently-published open trial with a sample of test anxiety patients (Prinz, Bar-Kalifa, Rafaeli, Sened, & Lutz, 2019).

This trial has also provided exciting psychophysiological insights on the mechanisms of imagery work (Bar-Kalifa, Prinz, Atzil-Slonim, Rubel, Lutz, & Rafaeli, 2019). In particular, we have found that physiological synchrony between therapists and clients in the imagery segments was tied to a stronger therapeutic bond. This finding speak to the theme of this year’s conference – reinventing the therapeutic relationship.

In the workshop, we will present the model underlying the adaptation of schema therapy for brief treatment of anxiety disorders, along with recent clinical insight on the use of imagery focused on current-life and on the future (Maurer & Rafaeli, in press, in Heath & Startup’s upcoming Creative Methods in Schema Therapy: Advances and Innovation in Clinical Practice; Routledge). We will utilize brief video demonstrations and in-vivo exercises to familiarize participants with the protocol.

Learning Outcomes:

1.      Theoretical understanding of the model integrating schema therapy and cognitive behavioral therapy for the treatment of anxiety disorders.

2.      Development of insight into the use of imagery focused on current-life and on the future.

3.      Practical competence in the application of a brief, schema-therapy inspired treatment protocol, applicable to various anxiety disorders.

About the workshop leaders:

Dr. Offer Maurer (Ph.D.) is a clinical psychologist, the founding director of 'The New Wave in Psychotherapy Program' at the Interdisciplinary Centre, Hertzliya. He is also the co-founder of the Israeli Institute for Schema Therapy and the Chairperson of the Israeli Association for Relational Psychoanalysis and Psychotherapy, he is also the founding director of the 'Gay-Friendly Therapists Team', a gay-friendly psychotherapy institute. A guest lecturer at various programs both in Israel and abroad. Works in private practice in Tel Aviv. His current writing attempts at theoretically bridging relational conceptualizations of self-multiplicity and experience-based clinical interventions in the spirit of Schema Therapy for severe personality disorders. A chapter he co-wrote with Rafaeli & Thoma titled ‘Working with Modes in Schema Therapy’ appeared in the book ‘Engaging Emotion in Cognitive Behavioral Therapy: Experiential Techniques for Promoting Lasting Change’ (Guilford Press).

Prof. Eshkol Rafaeli is a professor and the former director in the adult clinical program in the psychology department at Bar-Ilan University and a co-founder of the Israeli Institute for Schema Therapy. He completed his BA at the Hebrew University, and his PhD in clinical and personality psychology at Northwestern University. After interning at McLean Hospital/Harvard Medical School, he completed a post-doc in social psychology at NYU, and underwent training at the Minuchin Center for Family Therapy. In 2003, Eshkol joined the faculty of Barnard College, Columbia University, where he continues to serve as a research scientist. In his years in NY, Eshkol joined the staff of Jeffrey Young’s Schema Therapy Institute, where he was a therapist and a supervisor. Since returning to Israel in 2009, he’s headed the Affect and Relationships research lab in the Psychology Department and the Neuroscience Center at Bar-Ilan University. His research addresses affective and social cognitive processes in personality disorders and daily processes in close relationships, as well as clinical investigations of effectiveness and process in schema therapy for avoidant personality disorder. Eshkol is the co-author (together with Jeffrey Young and David Bernstein) of “Schema Therapy: Distinctive Features” (Routledge, 2010).

Why Schema Therapy?

Schema therapy has been extensively researched to effectively treat a wide variety of typically treatment resistant conditions, including Borderline Personality Disorder and Narcissistic Personality Disorder. Read our summary of the latest research comparing the dramatic results of schema therapy compared to other standard models of psychotherapy.

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