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Clinicians’ views on the clinical utility of a revised definition of schema and its implications for the treatment of depression

Published online by Cambridge University Press:  13 March 2014

Alan Howarth*
Affiliation:
Northumberland Challenging Behaviour Service, St George's Park, Morpeth, UK
Mark Freeston
Affiliation:
Institute of Neuroscience, Newcastle University and Newcastle Cognitive and Behavioural Therapies Centre, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
Katharina Reichelt
Affiliation:
Newcastle Older Adult Psychology Service, Akenside Offices, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
Ian A. James
Affiliation:
Northumbria University and Newcastle Older Adult Psychology Service, Akenside Offices, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
*
*Author for correspondence: Dr A. Howarth, Clinical Psychologist, Northumberland Challenging Behaviour Service, West Wing, St George's Park, Morpeth, Northumberland NE61 2NU (email: Alan.howarth@ntw.nhs.uk)

Abstract

The main objectives of this study were to compare the perceived utility of two definitions of schema (i.e. a standard Beckian vs. a revised definition). Fifty clinicians with varying degrees of training in cognitive behavioural therapy (CBT) received a presentation on the Beckian definition of schema before completing two questionnaires, one assessing the perceived utility of the definition, and another assessing the targets they would address in therapy and the techniques they would use to do so, using the Beckian definition. They then received a presentation on a revised definition before completing the questionnaires again; this time in relation to the revised definition. In a non-inferiority analysis the revised definition was rated as possessing not less clinical utility than the Beckian definition and was indeed rated higher. More targets and techniques were selected following the revised definition, relative to the Beckian definition. Further, there was a significant interaction between definition and targets and techniques selected, with a greater increase in the targets and techniques that are consistent with the revised definition. The results were independent of experience within mental health and practising CBT therapists. The revised definition was perceived to have clinical utility and the use of it in therapy would lead to a wider range of targets being addressed while using a wider range of clinical techniques. Importantly, those targets and techniques relate specifically to the revised definition. The implications of the results and future areas of research are discussed.

Type
Original Research
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

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References

Barry, ES, Naus, MJ, Rehm, LP (2004). Depression and implicit memory: understanding mood congruent memory bias. Cognitive Therapy and Research 28, 387414.CrossRefGoogle Scholar
Barry, ES, Naus, MJ, Rehm, LP (2006). Depression, implicit memory and self: a revised memory model of emotion. Clinical Psychology Review 26, 719745.CrossRefGoogle Scholar
Bartlett, FJ (1932). Remembering. Cambridge, UK: Cambridge University Press.Google Scholar
Beck, AT (1967). Depression: Causes and Treatment. Philadelphia: University of Pennsylvania Press.Google Scholar
Beck, AT, Rush, AJ, Shaw, BF, Emery, G (1979). Cognitive Therapy of Depression. New York: Guilford Press.Google Scholar
Beck, JS (1995). Cognitive Therapy: Basics and Beyond. London: Guilford Press.Google Scholar
Bieling, PJ, Kuyken, W (2003). Is cognitive case formulation science or science fiction? Clinical Psychology: Science and Practice 10, 5269.Google Scholar
Brewin, CR (1989). Cognitive change processes in psychotherapy. Psychological Review 96, 379394.CrossRefGoogle ScholarPubMed
Brewin, CR, Reynolds, M, Tata, P (1999). Autobiographical memory processes and the course of depression. Journal of Abnormal Psychology 108, 511517.CrossRefGoogle ScholarPubMed
Butler, G (1998). Clinical formulation. In: Comprehensive Clinical Psychology (ed. Bellack, A. S. and Hersen, M.), pp. 1–24. New York: Pergamon.Google Scholar
Clark, DA, Beck, AT, Alford, BA (1999). Scientific Foundations of Cognitive Theory and Therapy of Depression. New York: John Wiley & Sons Inc.Google Scholar
Gillham, B (2000). Developing a Questionnaire. London, UK: Continuum.Google Scholar
Horowitz, MJ (1991). Person Schemas and Maladaptive Interpersonal Patterns. Chicago, IL: Chicago University Press.Google Scholar
Ingram, RE, Miranda, J, Segal, ZV (1998). Cognitive Vulnerability to Depression. New York: Guilford.Google Scholar
James, IA, Reichelt, FK, Freeston, MH, Barton, SB (2007). Schemas as memories: implications for treatment. Journal of Cognitive Psychotherapy: An International Quarterly 21, 5157.CrossRefGoogle Scholar
James, IA, Southam, L, Blackburn, IM (2004). Schemas revisited. Clinical Psychology and Psychotherapy 11, 369377.Google Scholar
Kuyken, W, Brewin, CR (1994). Intrusive memories of childhood abuse during depressive episodes. Behaviour Research and Therapy 32, 525528.Google Scholar
Kuyken, W, Fothergil, CD, Musa, M, Chadwick, P (2005). The reliability and quality of cognitive case formulation. Behaviour Research and Therapy 43, 11871201.Google Scholar
Leahy, RL (2003). Cognitive Therapy: A Practitioner's Guide. London, UK: Guilford.Google Scholar
Minsky, ML (1975). A framework for representing knowledge. In: The Psychology of Computer Vision (ed. Winston, P. H.), pp. 211277. New York: McGraw-Hill.Google Scholar
Power, MJ, Dalgleish, T (1997). Cognition and Emotion: From Order to Disorder. Hove: Psychology Press.Google Scholar
Rehm, LP, Naus, MJ (1990). A memory model of emotion. In: Contemporary Psychological Approaches to Depression: Theory, Research and Treatment (ed. Ingram, R. E.), pp. 2335. New York: Plenum.Google Scholar
Safran, ZV (1990). Towards refinement of cognitive therapy in light of interpersonal theory: 1. theory. Clinical Psychology Review 10, 87105.CrossRefGoogle Scholar
Schank, RC, Abelson, R (1977). Scripts, Plans, Goals and Understanding, Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
Segal, ZV, Williams, JMG, Teasdale, JD, Gemar, M (1996). A cognitive science perspective on kindling and episode sensitisation in recurrent affective disorder. Psychological Medicine 26, 371380.Google Scholar
Teasdale, JD (1988). Cognitive vulnerability to persistent depression. Cognition and Emotion 2, 247274.Google Scholar
Teasdale, JD, Barnard, PJ (1993). Affect, Cognition and Change: Re-modelling Depressive Thought. Hove: Lawrence Erlbaum Associates.Google Scholar
Warr, PB (1980). An introduction to models in psychological research. In: Models of Man (ed. Chapman, A. J. and Jones, D. M.). Leicester, UK: British Psychological Society.Google Scholar
Williams J, MG, Watts, FN, MacLeod, C, Mathews, A (1997). Cognitive Psychology and Emotional Disorders, 2nd edn, Chichester: Wiley.Google Scholar
Young, JE (1994). Cognitive Therapy of Personality Disorders: A Schema-focused Approach. Sarasota, FL: Professional Resource Exchange Inc.Google Scholar
Young, JE, Brown, G (1990). Young Schema Questionnaire. New York: Cognitive Therapy Centre of New York.Google Scholar
Young, JE, Klosko, JS, Weishaar, ME (2004). Schema Therapy: A Practitioner's Guide. New York: Guilford Press.Google Scholar
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