General Overview 

Many Cluster C personality disorder (PD) patients get burned out, depressed, exhausted, or stuck in another way. This is because they have learned to cope with feelings like incompetence, insecurity, or loneliness by avoiding, having others taking over control or by keeping everything under control themselves, and by striv-ing for perfection. In the short run these coping styles are successful, but in the long run they lead to e.g., stress related complaints. 

Schema Therapy (ST) has established effectiveness and efficacy in Borderline Personality Disorder (Farrell et al., 2009; Giesen-Bloo et al., 2006; Nadort et al.,2009). In a first randomized controlled trial by Bamelis and colleages (2014) Schema Therapy (ST) was also effective for cluster C PDs. However, more research is needed, especially for group ST formats. Treatment of patients in Cluster C is as demanding and complex as treatment of BPD, but it has its own spe-cific challenges. 

This symposium will introduce a Group Schema Therapy (GST) model for Cluster C PDs, that is studied in the Netherlands. A short presentation of the study background and design is provided. Hereafter, an introduction with facts and figures on Cluster C PD diagnoses and treatments will be presented. This is followed by two clinical presentations. One will demonstrate how experiential techniques can be adapted to be used in a GST format for Cluster C. The other will show how therapist and patient can work with anger in individual sessions, which are part of the treatment format. 

At the end, there is room for questions and discussion. Throughout the symposium, specific challenges in working with Cluster C PDs, such as breaking through the avoidance, handling dependence and crises, and exposure to intense feelings such as anger, will be addressed.

Segment 1

Title: Background and study design pilot GST Cluster C PDs

Presenter: Marleen Rijkeboer

Schema Therapy (ST) has established effectiveness and efficacy in Borderline Personality Disorder (Farrell et al., 2009; Giesen-Bloo et al., 2006; Nadort et al.,2009). In a first randomized controlled trial by Bamelis and colleages (2014) individual Schema Therapy (ST) was also effective for cluster C PDs. However, research on the effectiveness of group ST is lacking. Therefore, in the Netherlands two formats of group schema therapy for Cluster C PDs are being studied. One of these formats is developed by Sijbers et al (2017). In this symposium this specific format will be elaborated upon. First a short overview of the background and design of the study is provided.

Segment 2

Title: Facts and figures about Cluster C PDs

Presenters: Wiesette Krol & Eline Mollema

This theoretical presentation will give an introduction into the treatment of Cluster C personality disorders. Facts and figures are shown on the prevalence, comorbidity, and etiology of Cluster C personality disorders. Finally, data are presented and discussed of a pilot study into group therapy for Cluster C PDs in Maastricht and Venlo.

Segment 3

Title: Helping to break through the avoidance in Cluster C PDs with experiential techniques in a group

Presenters: Rosi Reubsaet & Judith Hollands

In this practical presentation the two presenters will present a short power-point presentation to high-light some special features of working with cluster C PDs in group schema therapy. They will also address the differences between the various stages of schema therapy, depending on the level of healthy adult functioning, and what this means for limited reparenting. The majority of the presentation will be used to show a live example of how therapists can do this in a session using ex-periential techniques, which are specifically adapted for working with Cluster C PD patients in group schema therapy. The participants will be invited to participate actively.

Segment 4

Title: Stimulating Anger in Cluster-C Personality Disorders

Presenter: Guido Sijbers

Dealing with anger is an issue for many, and especially difficult for patients in Cluster C. The indi-vidual sessions, part of the GST format, are in theme related to, and in a way preparatory to the group sessions. In these individual sessions the patient receives extra support and stimulation to deal with difficult issues in the group, such as anger. During the presentation we show by means of a short roleplay how to help the patient to connect and deal with anger.

About the Presenters:

Marleen Rijkeboer

Marleen Rijkeboer is a clinical psychologist and psychotherapist. She is an Advanced Certified Schema Therapist, Supervisor and Trainer. Marleen is a special professor for personality disorders at the Department of Clinical Psychological Science on the Faculty of Psychology and Neuroscience at Maastricht University in the Netherlands.

Wiesette Krol

Wiesette Krol is a clinical psychologist, Cognitive Behavior Therapist Supervisor, and Schema Therapist Trainer/Supervisor. 

From 1997- 2000, Wiesette was trained and supervised by Jeffrey Young, the founder of Schema Therapy. She has also been trained and supervised in Group Schema Therapy by Ida Shaw and Joan Farrell.

For the past 15 years, Wiesette has worked with schema therapy, treating personality disorders (cluster B and C), individually and in groups, along with ambulant and day treatment care. Previously, Wiesette was the head of the Department of Personality and Developmental Disorders at the RIAGG Maastricht. Currently, she works at the Academic Hospital in Maastricht as Manager/Clinical Psychologist. 

Since its formation in 2007, Wiesette has been a Senior Member of the Dutch Schema Therapy Society, and is an ISST Advanced Certified Schema Therapist since 2008.

Rosi Reubsaet

Rosi Reubsaet is a clinical psychologist and psychotherapist(Dutch BIG registration).

She is ISST registered as advanced level individual schematherapy and groupschematherapy. She is registered as supervisor CBT and schematherapy for the Dutch Schematherapy Society and CBT society.  

In 2009 she started working as a clinical psychologist in an academic setting (together with Arnoud Arntz and Hannie van Genderen), participating in research treating personality disorders with Schematherapy. She worked at the Riagg Maastricht, predominantly at the schematherapeutic daycentre for patients with borderline personality disorders. She has been trained and supervised by Ida Shaw and Joan Farrell. 

Since 2016, she works at Vincent van Gogh, a large mental health care organization in the Netherlands, where she treats PD-patients with individual- and group-schematherapy, in an outpatient and daytreatment setting.  

Since 2013 she is involved in the training and supervision of schematherapists, CBT-therapists and clinical psychologists in the Netherlands, Belgium and Germany. She has been presenting on several national and international conferences.

Judith Hollands

Judith Hollands is a Senior Registered Drama Therapist and Senior Schema Therapist in the Dutch Schema Therapy Register. Since 2009, Judith has been working with Schema Therapy, and is one of the founders of combining Psychodrama Therapy and Group Schema Therapy in a day center for Borderline Personality Disorder in Maastricht. 

Since 2013, Judith has been teaching workshops, with a focus on cooperation in multidisciplinary psychotherapy teams and in using experiential techniques in a Schema Therapy context. She is a co-founder of the Academy of Schema Therapy (Academie voor Schematherapie), and maintains a private practice.

Guido Sijbers

Guido Sijbers is a clinical psychologist/psychotherapist, an Advanced Level Cognitive Behavioral Therapist, and an Advanced Certified Schema Therapist and Trainer/Supervisor.

He works with Schema Therapy to treat personality disorders using individual and in group therapy in tertiary (outpatient) health care in Maastricht, the Netherlands. Previously Guido collaborated with Arnoud Arntz at the University of Maastrict, and was in private practice in Cologne, Germany. He has been training other therapists in Schema Therapy since 1999 (ptkoeln.de).

He is one of the founders of academievoorschematherapie.nl

Since the Dutch Membership of Schema Therapy was formed in 2007, Guido has been a Senior Member, and received Advanced Certification by ISST in 2008 as a Trainer/Supervisor in individual therapy, along with Advanced Certification for Group Schema Therapy as a Trainer/Supervisor in 2014.