Introduction
The book Cognitive Therapy for Personality Disorders: A Schema Focused Approach is written by Jeffery Young and focuses on the author’s method of helping clients address various personality disorders. Young developed a distinct form of aiding patients who did not respond to other treatment methods, such as traditional Cognitive-Behavioral Therapy (CBT). Young named his method “schema therapy,” as a reference to various schemas an individual develops to satisfy their needs. Young describes the premise of schema therapy and how to apply it in this book. CBT, in general, has been a widely acknowledged psychological technique deemed as one of the most effective ways for treating multiple disorders, however, not all people are in remission after CBT. Schema therapy is the combination of various treatment methods that allow modifying the throughs and behavior of an individual and address complex cases of personality disorders by teaching clients about their needs and healthy ways of satisfying them.
Premise For Writing This Book
Young is the most qualified individual among mental health professionals whose work on schema therapy can be used as a professional reference. At the beginning of this book, Young provides a quick overview of his professional qualifications, mainly the fact that he developed schema therapy as a result of his work with patients who were resistant to other methods of treatment. Hence, since Young created schema therapy, it is suitable for him to describe his methodology in a book.
The author is qualified to write on the topic of psychology and therapy because Young has a doctorate degree in this field. Moreover, through his theoretical knowledge and practical experience, Young has developed a novel approach to treating personality disorder – schema therapy, which is discussed in this book. Hence, the author clearly communicated the premise for writing this book and provided evidence of his Preface qualifications. This book is helpful when developing a schema therapy strategy for an individual. The main argument for writing this book is the fact that Young is the original creator of schema therapy. Since he developed this method, it seems valid that Young wrote a book that other mental health professionals can use as a guide in their work with patients.
Young described the premise for this book by referring to CBT and explaining some of the downfalls of this method since some patients of Young appeared to be treatment-resistant. He establishes the premise for this book and his approach by explaining the basis of CBT, its goals, disorders that can be treated with it, and principal issues. Initially developed by Beck, this method is helpful when working with patients who suffer from illnesses such as narcissism or other personality disorders. CBT is based on the idea that by addressing the patient’s thoughts and behavior, the therapist can help them change some patterns of behavior that lead to issues and, therefore, help these individuals overcome their mental health problems (Young, 10). Since schema therapy is based on CBT, one can assume that Young has to be qualified and have an in-depth knowledge of this approach as well. At the beginning of this book, Young explains that he has been working as a director of research and training at Beck’s CBT center for approximately ten years (5). As a result, since the author has a background in CBT, one can assume that his premise for developing schema therapy is justified.
Since the central premise for writing this book is the author’s experience and research, including the practical application of the schema therapy, initially, I thought that to confirm the efficiency of his methods, I should look through research and evidence-based studies that demonstrate the efficiency of schema therapy. Hence, it would be more helpful if the author would provide more proof that the use of schema therapy is useful, for example, clinical studies. But in general, since Young developed this approach, one can assume that he is the most qualified individual who can write about the methodology of schema therapy.
Therefore, in Cognitive Therapy for Personality Disorders: A Schema Focused Approach, Young thoroughly explains his professional background as a therapist, his use of CBT with clients, and issues he faced with treatment-resistant individuals. As a result, Young clearly states the premise for writing this book, which persuaded me that he was thorough in his research – he developed a method, based on his theoretical and practical knowledge, that can be used to treat complex cases of personality disorders. Young is the founder of the Shema Therapy Institute and Cognitive Therapy Centers. This leads one to believe that Young was thorough in his research since he used a combination of different methods used by psychotherapists to create a new one. However, including a reference to research and studies that confirm the effectiveness of schema would be helpful for supporting the premise of this book.
New Truths
Although previously I was aware of the schema therapy approach, Young was able to disclose this method in depth, explaining the intricate details of how maladaptive schemas can result in the development of personality disorders and psychological struggles later in life. Most importantly, this book uncovered that “borderline, narcissistic, avoidant, dependent, obsessive-compulsive, passive-aggressive, and histrionic personality disorders” can be treated using the same approach (Young, 25). Hence, this helped me understand how maladaptation to different situations results in the development of these disorders, while previously I had a generalized understanding of what a schema is and what meaning it has in one’s behavior.
Young reminded me that schemas develop as a response to unmet needs, and therefore, the goal of the therapy is to heal these wounds and help a person recognize their needs and learn how to satisfy them on their own. Ideally, these maladaptive responses should be replaced with behavioral schemas that allow a patient to identify and meet these needs, therefore not triggering the maladaptive schemas. The issue of unmet needs can be easily understood or explained to a patient requiring counseling since the concept is simple: people require “connection, mutuality, reciprocity, flow and autonomy” (Young, 50). A coping mechanism is, therefore, a way in which a person responds to a traumatic experience, usually during childhood. Intriguingly, different individuals react in a different way. For example, some choose to escape while others overcompensate. Hence, this book broadened my understanding of needs and the ways of adapting to unmet needs.
Moreover, these schemas affect a person’s life since one faces situations that trigger the maladaptive response. As a result, a person can be stuck in a state of self-defeat, which consequentially has a negative impact on one’s mental health and well-being. One aspect of the book that is very helpful for mental health professionals is the case studies the author presents when discussing specific schemas. This is especially helpful in practice, considering the fact that the premise of this therapy is that it helps address cases that cannot be addressed through other therapies, meaning that one can use it for complex cases.
The author also distinguishes between core schemas, primary schemas, and secondary schemas, which is a helpful classification. This book offers new insights into the issues of borderline personality disorder and narcissism that are not described in other therapy approaches. Next, with this book, one can understand the thought process that led to the creation of schema therapy. As Young explains, this method is an integration of gestalt therapy, CBT, and other methods. However, one can argue that an individual who is not familiar with these different treatment approaches can use schema. With this book, a mental health professional receives a guide on how to conduct an assessment and guide treatment. With the evaluation stage, one can use Young’s questionnaire to identify schemas and coping mechanisms.
Finally, an essential point that one can discover with this book is the essential meaning of the therapist-client relationship. For example, as Young explains, all people have a method for dealing with traumatic experiences, and for some, this results in a personality disorder. Hence, this method allows a therapist to show compassion for their client and, in a way, revert from a stigma surrounding mental health since these personality disorders can be viewed as a way of adapting to different life events.
Controversial Statements
One of the premises of schema therapy is that other types of methodologies developed to treat personality disorders prove to be ineffective. A reader can get this controversial impression from the book since schema therapy is advertised as an advanced method that can be used for difficult cases. However, Young does not argue that other therapies are ineffective. In fact, he describes his method as an “integrative approach” that combines therapies such as gestalt, CBT, and others. The integration of psychotherapy indicates that this method offers more than others by using the best features of different psychotherapeutic treatments.
An immediate controversy is a statement that schema therapy is a simple model. When describing his method, Young refers to this approach as a definition of “parsimony and simplicity” (20). However, one can argue that schema, in fact, is a challenging method to use, partially because it integrates other treatment techniques and because it aims to explain different methods of adaptation to satisfy one’s needs. Stating that the method is simple may be undermining the depth of analysis that goes into understanding how schemas develop. Moreover, there is a challenge for the mental health professional to explain to their clients their schemas and why these developed in a simple and easy to understand way.
Conclusions
When reviewing the content and premise of Young’s book Cognitive Therapy for Personality Disorders: A Schema Focused Approach, I would conclude that it is a must-read for people who plan on working as mental health professionals, especially because the author includes a variety of case studies and dialogs with patients that illustrate what issues this therapy addresses and how. For example, to address the Lonely Child issue that one of Young’s patients, Carl, had, Young recommended addressing the detached self-soother schema. The patient was in an intimate relationship but had difficulty opening up to his partner and, therefore, could not receive love. I think that this approach to explaining how a therapy method works are extremely helpful and allows practitioners to grasp the basics of a therapy method easily.
Moreover, I would recommend this book for people who are not involved with psychology, as a self-help guide that can help them recognize their needs using the examples of Young’s clients. Although this is not an ideal approach, and it is best if a patient works with a trained professional to recognize their schemas, this book provides sufficient detail to help recognize some maladaptive schemas. At the end of Cognitive Therapy for Personality Disorders: A Schema Focused Approach, there is an easy-to-understand guide, which Young developed specifically for patients.
Finally, this book helped me gain an in-depth understanding of the classroom content. Most importantly, I was able to look at patient cases and interactions that helped me comprehend how schema can be used in practice, which is essential for any mental health professional. Hence, by combining real-life examples and conversations with patients to what I studied in class, I was able to understand how to use schema therapy in practice, how to talk to patients to help them recognize their schemas, and how to address some standard maladaptive behavior.
Reference
Young, Jeffrey E. Cognitive Therapy for Personality Disorders: A Schema Focused Approach. 3rd ed. Sarasota Fl. Professional Resource, 1999.