Positive schemas in schema therapy with older adults: clinical implications and research suggestions

2020 ◽  
Vol 48 (4) ◽  
pp. 481-491
Author(s):  
Arjan C. Videler ◽  
Rita J.J. van Royen ◽  
Marjolein J.H. Legra ◽  
Machteld A. Ouwens
Keyword(s):  
Older Adults ◽  
Personality Disorder ◽  
Empirical Support ◽  
Later Life ◽  
Adaptive Behaviour ◽  
Schema Therapy ◽  
Complex Disorders ◽  
Early Maladaptive Schema ◽  
Therapy Model ◽  
Positive Schemas

AbstractBackground:Schema therapy is an effective treatment for borderline personality disorder and other complex disorders. Schema therapy is feasible in older adults, and the first empirical support for its effectiveness in later life was provided in older patients with a cluster C personality disorder. The central concept of the schema therapy model is the early maladaptive schema (EMS). Early adaptive schemas (EAS) give rise to adaptive behaviour, and they also emerge during childhood, when core emotional needs are adequately met by primary caregivers.Aims:To examine the concept of EAS and its application in schema therapy with older adults.Method:Literature review and case example: the role of EAS in schema therapy with older adults is discussed and suggestions for integrating EAS in schema therapy in later life are proposed.Results:Directing attention in therapy to EAS may help strengthen the healthy adult mode, and it might also help change a negative life review. Working with positive schemas may be an important avenue for re-awakening positive aspects of patients, reinforcing the therapeutic relationship, creating a positive working atmosphere, and also for facilitating the introduction of experiential schema therapy techniques.Conclusions:This review suggests that positive schemas may be important vehicles of therapeutic change when working with older people. There is a need for validating the Young Positive Schema Questionnaire (YPSQ) in older adults, and for examining whether integrating EAS in schema therapy with older adults indeed has a positive effect on therapy outcome.

Schema Therapy With Older Adults

2018 ◽  
Author(s):  
A.C. Videler
Keyword(s):  
Older Adults ◽  
Personality Disorders ◽  
Oldest Old ◽  
Later Life ◽  
Schema Theory ◽  
Schema Therapy ◽  
Maladaptive Schemas ◽  
Old Patients ◽  
Complex Disorders ◽  
The Impact

Schema therapy has evolved since the late 1980s as an efficacious and increasingly widely used psychotherapeutic treatment for personality disorders and many other complex disorders that correlate with underlying maladaptive schemas. Only recently, attention among clinical geropsychologists has been growing for the application of schema therapy in older adults. Schema therapy is very feasible for both therapists and older patients. Schema therapy is an integrative psychotherapy, which draws on the cognitive-behavioral, attachment, psychodynamic, and emotion-focused traditions. In this treatment model, early maladaptive schemas are considered core elements of persistent and pervasive psychopathology, including personality disorders. The goal of treatment is to decrease the impact of maladaptive schemas and to replace negative coping responses and maladaptive schema modes with more healthy alternatives so that patients succeed in getting their core emotional needs met. The emerging attention for schema therapy in older adults is in line with the increased attention for personality disorders in later life, and also with the maturing field of psychotherapy for older adults. The first scientific evidence for the feasibility and the effectiveness of schema therapy has recently been shown. Despite these developments, much work is still to be done. The question is whether schema theory, which was developed for adults in young and middle adulthood, equally applies to those in later life. Although the first tests of effectiveness of schema therapy in older adults are encouraging, age-specific adaptations of existing therapy protocols, both for individual and group schema therapy, are wanted. Furthermore, the research that has been conducted so far has focused on the young-old. Especially for the growing and highly complex group of oldest-old patients, the development of feasible and effective schema-based interventions is needed. Integrating age-specific moderators for change, such as wisdom enhancement, attitudes to aging, and integrating the action of positive schemas, deserves recommendation.

scholarly journals Personality disorders in later life: epidemiology, presentation and management

2020 ◽  
Vol 26 (4) ◽  
pp. 208-218
Author(s):  
Ayesha Bangash
Keyword(s):  
Older Adults ◽  
Personality Disorder ◽  
Older People ◽  
Medical Care ◽  
Personality Disorders ◽  
Late Life ◽  
Later Life ◽  
Enormous Amount ◽  
Expected Increase ◽  
Growing Population

SUMMARYDespite the enormous amount of literature on medical care of older people, personality disorders in late life have been given little attention. Clinicians tend not to assign this diagnosis to older adults in view of limited research into, and therefore limited awareness of, this topic. This article aims to promote better understanding of this subject in view of the growing population of older people and hence an expected increase in the number of personality disorder cases.

scholarly journals Adapting group schema therapy for older adults with personality disorders: lessons learnt

2021 ◽  
Vol 14 ◽  
Author(s):  
A. C. Videler ◽  
K. A. van Beest ◽  
M. A. Ouwens ◽  
G. Rossi ◽  
R. J. J. van Royen ◽  
...  
Keyword(s):  
Older Adults ◽  
Personality Disorder ◽  
Primary Outcome ◽  
Treatment Protocol ◽  
Brief Symptom Inventory ◽  
Individual Treatment ◽  
Schema Therapy ◽  
List Type ◽  
Younger Adults ◽  
Small Effect Size

Abstract A first empirical study into group schema therapy in older adults with mood disorders and personality disorder (PD) features has shown that brief group schema therapy has potential to decrease psychological distress and to change early maladaptive schemas (EMS). Effect sizes however were smaller than those found in similar studies in younger adults. Therefore, we set out to adapt the treatment protocol for older adults in order to enhance its feasibility and outcome in this age group. We examined this adapted protocol in 29 older adults (mean age 66 years) with PDs from four Dutch mental health institutes. The primary outcome was symptomatic distress, measured by the Brief Symptom Inventory. Secondary outcomes were measured by the Young Schema Questionnaire, the Schema Mode Inventory, and the short version of the Severity Indices of Personality Problems. Contrary to our expectations, the adapted treatment protocol yielded only a small effect size in our primary outcome, and no significant improvement in EMS, modes and personality functioning. Patients pointed out that they were more aware of their dysfunctional patterns, but maybe they had not been able yet to work on behavioural change due to this schema therapy treatment being too brief. We recommend more intensive treatment for older patients with PDs, as they might benefit from more schema therapy sessions, similar to the treatment dosage in younger PD patients. They might also benefit from a combination of group therapy and individual treatment sessions. Key learning aims (1) How to adapt group schema therapy for older adults. (2) How to explore feasibility and outcome. (3) Treat older personality disorder patients as intensively as younger adults.

scholarly journals Gestandaardiseerd meten van persoonlijkheids­stoornissen bij ouderen

2020 ◽  
Keyword(s):  
Older Adults ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Later Life ◽  
The Elderly ◽  
Classification Systems ◽  
Diagnostic Tools ◽  
Diagnostic Process ◽  
Co Morbidity ◽  
Personalized Approach

The double ageing evolution in Europe is a tremendous challenge for health care. Older adults with a personality disorder place an additional burden: they have more somatic and psychiatric co-morbidity than those without a personality disorder. Moreover, they experience less quality of life than individuals without personality disorders. This is in sharp contrast to the dearth of empirical research concerning the construct of personality disorders in later life, the very limited amount of available diagnostic tools, criteria of classification systems like DSM not being attuned to the elderly context and the lack of age-neutrality of popular instruments to measure personality disorders. Therefore, in the Netherlands and Belgium a start was made to develop and validate age-specific instruments and to examine the applicability of the alternative dimensional-hybrid DSM-5 classification of personality disorders in older adults. These recent developments and how to apply them for a personalized assessment in older adults will be discussed. Finally, we advise a phased test-based diagnostic approach in which the above-mentioned instruments, combined with measures of adaptive features or more specific tests, can contribute to an assessment optimizing the balance between restricting the load for the older patient and still being sufficiently comprehensive to result in a personalized approach of the diagnostic process.

scholarly journals Schema therapy with older adults: call for evidence

2012 ◽  
Vol 24 (7) ◽  
pp. 1186-1187 ◽  
Author(s):  
A. C. (Arjan) Videler ◽  
R. J. J. (Rita) van Royen ◽  
S. P. J. (Bas) van Alphen
Keyword(s):  
Older Adults ◽  
Personality Disorders ◽  
Dialectical Behavior Therapy ◽  
Literature Search ◽  
Combined Treatment ◽  
Later Life ◽  
Schema Therapy ◽  
Comorbid Depression ◽  
Medication Treatment ◽  
Considerable Body

Although there is a considerable body of evidence supporting the efficacy of psychotherapy for personality disorders (PD), as yet, effect studies focusing on treatment of PD in older adults are lacking. In a literature search (1980–2011) with Pubmed Medline and PsycINFO with the terms “personality disorders,” “psychotherapy,” “treatment,” “elderly,” and “older adults,” it appeared that no randomized and controlled effect studies have been conducted on the treatment of PD in later life. Just one study examined the efficacy of dialectical behavior therapy (DBT) in a small randomized clinical trial among older people with comorbid depression and PD (N = 35; Lynch et al., 2007). However, it is surprising that the number of PD in remission (in total 16 out of 35) was almost the same with medication treatment alone (n = 7) compared to combined treatment of medication and DBT (n = 9). Moreover, this study was not exclusively focused on the treatment of PD.

scholarly journals The effectiveness of adapted schema therapy for cluster C personality disorders in older adults – integrating positive schemas

2021 ◽  
Vol 21 ◽  
pp. 100715
Author(s):  
L. van Donzel ◽  
M.A. Ouwens ◽  
S.P.J. van Alphen ◽  
S. Bouwmeester ◽  
A.C. Videler
Keyword(s):  
Older Adults ◽  
Personality Disorders ◽  
Schema Therapy ◽  
Positive Schemas

Leisure Activities and the Subjective Well-Being of Older Adults in Croatia

GeroPsych ◽  
2018 ◽  
Vol 31 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Ljiljana Kaliterna Lipovčan ◽  
Tihana Brkljačić ◽  
Zvjezdana Prizmić Larsen ◽  
Andreja Brajša-Žganec ◽  
Renata Franc
Keyword(s):  
Older Adults ◽  
Leisure Activities ◽  
Leisure Activity ◽  
Later Life ◽  
Perceived Health ◽  
Well Being ◽  
Hierarchical Regression ◽  
Subjective Well Being ◽  
Convenience Sample ◽  
Financial Status

Abstract. Research shows that engagement in leisure activities promotes well-being among older adults. The objective of the current study was to examine the relationship between subjective well-being (flourishing) and leisure activities (total number of different activities in the previous year) in a sample of older adults in Croatia, thereby considering the variables of sex, marital status, financial status, and self-perceived health. The differences in the examined variables between the groups of older adults who reported to be engaged in new activities with those who did not were also examined. The sample of N = 169 older adults aged 60 years and above was drawn from a convenience sample of adult internet users in Croatia. Participants reported their self-perceived health and the number of leisure activities they engaged in over the previous year as well as completing the Flourishing Scale. Hierarchical regression analyses indicated that older adults who were engaged in more various leisure activities, who perceived better financial status, and who were married reported higher levels of flourishing. A comparison of the two groups of older adults with and without engagement in leisure activities showed that those engaged in at least one leisure activity were more likely to be women, reported higher levels of flourishing, and perceived their own financial status as better. This study indicated that engaging in leisure activities in later life might provide beneficial effects for the well-being of older adults.

Sign in / Sign up

Export Citation Format

Share Document