chiara.difrancesco's blog

ESSENTIAL ELEMENTS IN SCHEMA THERAPY FOR COUPLES/MARRIAGES
Published by the ISST Couple/Marital Subcommittee
Drafted by Chiara DiFrancesco, Ph.D. Chairperson

a) There must be a significant focus on both individual ST for each partner as well as joint couple sessions. An individual schema therapy work up, with an individual attachment to the therapist is essential. This includes the standard inventories: YSQ-L3, YP1-1, SMI 1.1 & the Multimodal Life History Inventory, plus the therapist performing a detailed Conceptualization sheet for each partner and engagement in mode work.
b) There is a significant individual focus as well a joint focus, the method being individually applied by the therapist according to the circumstances.
c) There is full disclosure between partners.
d) We do not see the boundary issues which many current therapies have concerns about, as the roles of individual therapist and therapist for the couple relationship are clearly defined and consented to by both parties up-front.
e) Situations where there may be a conflict of interest are also clearly assessed and at least discussed with the clients also up front, and when these exceptions occur then schema therapy for the couple to heal the relationship is not pursued. There are other exceptions when schema therapy for the couple is pursued even with a conflict of interest regarding saving the relationship, however with the goals re-defined.
f) This combination of helping the relationship and persons is far more effective than having separate therapists for individual and couples, even when one partner starts later. We are much more adeptly able to evaluate the behaviors and modes of the partners and how they trigger each other.
g) Actually dealing with the client in a triggered mode happens readily in the individual/joint ST model both with partner and therapist. And we consider this an important essential element to the healing process. This can happen even with appropriate warnings of how a client might get triggered by the fact that the therapist is also the partner's therapist, and brings up excellent core material to actually work through in the therapy.
h) As the clients progress through ST for couples, we “up” the challenge and the triggers in the session, to help them strengthen their fight against their respective schemas, and resort to either vulnerable child or healthy adult modes as more effective coping techniques/tools.
i) In order to use this method in therapy, the schema therapist needs to be able to actually promote attachment with him or herself and the client, and fill some of the needs; otherwise the client will not be able to overcome the triggering situation. This happens best individually between client and therapist alone, but bears fruit in the joint sessions, which each partner feeling the understanding and connection with the schema therapist.
j) On the topic of dealing with couples where there are multiple affairs in the history, we reflected upon the components of not only Detached Self-Soother and Punitive Parent modes frequently involved, but also the Impulsive Child mode and activation of the Entitlement schema involving GREED with multiple extra-marital relationships. It is a failure to have a normal internalized "stop" mechanism which has components of both impulsivity and entitled greed.