Schema Therapy for Eating Disorders

Schema Therapy is an innovative transdiagnostic treatment model that is ideally suited to the treatment of eating disorders, and is well equipped to address the rigidly held belief systems, characterological traits, affective instability, trauma-based symptomatology and comorbidities that have been shown to interfere with clinical outcomes in eating disorders. Schema Therapy has demonstrated promising preliminary findings for eating disorders , including one randomised controlled trial (Joshua, 2023). Further, there is robust evidence for the effectiveness of schema therapy in the treatment of disorders that are frequently comorbid with eating disorders, and which appear to interfere with the effectiveness of first-line treatments, including borderline, cluster c, and narcissistic PDs, chronic depression, and complex trauma.

 

The workshop will provide therapists with an opportunity to learn powerful techniques for working with eating disorders, including those with entrenched beliefs, high complexity and comorbidity (e.g. OCD, rigid personality traits, PTSD). Anyone interested in learning to apply the schema therapy mode work to assist people with eating disorders would benefit from this workshop. The workshop will provide participants with practical experience and guidance in the use of innovative versions of imagery, chair work and other techniques for change. Videos and demonstrations will be used to illustrate experiential change techniques. Training will specifically include working with vulnerable [child] modes, limited reparenting skills, bypassing avoidant or overcompensatory coping modes, and fighting punitive (self-critical) or guilt inducing thinking patterns that drive eating disorder behaviours. Participants will receive handouts that they can use in their clinical work.

The workshop will offer you methods to cope with these challenging situations and will include:

• Methods to formulate complex eating disorder thoughts, behaviours, urges, & comorbid disorders using schema ‘modes’
• Imagery & chair-work to set limits on self-defeating ’inner critic’ modes
• Recognise & learn to work with common coping modes in Eating Disorders including: Overcontroller modes, and Helpless Surrenderer modes
• Empathic confrontation & chair-work to bypass strong coping modes
• Working with clients who are reluctant to participate in experiential work & to connect with emotions.
• Methods to access vulnerability & distress in eating disorders in order to enhance healing.
• Enhancing client’s Healthy Adult mode in treatment.
• The latest evidence-base for Schema Therapy with Eating Disorders & common comorbidities

Program

Day 1:

9.00 – 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

1.30 – 11.50 Coffee and tea break

11.50– 13.00 Modes & Mode Maps

• Review of the modes relevant to eating disorders
• Introducing some new eating disorder modes
• Differentiating modes & linking to specific eating behaviours (dietary restraint, bingeing, purging, overexercise, rituals)
• Getting to know the Overcontroller mode
• Group Exercise - Developing a mode map for your eating disorder clients

13.00 – 14.00 Lunch break

14.00 – 15.30

• Schema assessment & education of eating disorders from a schema therapy perspective.
• Identification of unmet needs & schemas that drive Eating Disorders
• Exploring agendas and fears of recovery linked to coping modes
  
  

15.30 – 15.50 Break

15.50 – 17.00

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 break between 11.30 and 11.50)

• Experiential Techniques in working with eating disorders
• Working with Critic Modes (chairwork)
• Bypassing the Overcontroller mode (therapist plays Vulnerable Child)
• Group Exercise: Bypassing the Overcontroller mode (therapist plays Devil’s Advocate)
  
  

13.00 – 14.00 Lunch break

14.00- 15.30

Variations in Imagery Rescripting

15.30 – 15.50 Break

15.50 – 17.00

• Empathic Confrontation with Coping Modes in Eating Disorders
• Common pitfalls and issues
• Questions & opportunity to discuss cases (supervision)