Psych Vivas · Psychotherapy
Schema therapy — structured clinical viva
Fellowship viva on schema therapy definition, modes, techniques, evidence, comparators, and stepped care.
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Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
You are the psychiatry registrar. A 28-year-old with recurrent self-harm after relationship ruptures and a lifelong defectiveness belief is referred for 'schema therapy'. Define EMS, coping styles and modes; outline limited reparenting and core techniques; summarise landmark evidence (Giesen-Bloo; Bamelis or group ST; Nadort pearl); contrast with DBT and TFP; and describe stepped care if specialist ST is unavailable.
Interpretation
Reveal interpretationShowHide
Markers want a structured professional answer: EMS definition, surrender/avoidance/overcompensation, mode families, limited reparenting without boundary myths, named techniques, Giesen-Bloo and at least one of Bamelis / Farrell / Arntz, Nadort implementation pearl, ST vs DBT/TFP, and honest stepped care when fidelity is incomplete.[1][4][5][7]
References8ShowHide
- [1]Giesen-Bloo J, van Dyck R, Spinhoven P, et al. Outpatient psychotherapy for borderline personality disorder: randomized trial of schema-focused therapy vs transference-focused psychotherapy Arch Gen Psychiatry, 2006.PMID 16754838
- [2]Farrell JM, Shaw IA, Webber MA A schema-focused approach to group psychotherapy for outpatients with borderline personality disorder: a randomized controlled trial J Behav Ther Exp Psychiatry, 2009.PMID 19176222
- [3]Nadort M, Arntz A, Smit JH, et al. Implementation of outpatient schema therapy for borderline personality disorder with versus without crisis support by the therapist outside office hours: A randomized trial Behav Res Ther, 2009.PMID 19698939
- [4]Bamelis LL, Evers SM, Spinhoven P, Arntz A Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders Am J Psychiatry, 2014.PMID 24322378
- [5]Bamelis LL, Renner F, Heidkamp D, Arntz A Extended Schema Mode conceptualizations for specific personality disorders: an empirical study J Pers Disord, 2011.PMID 21309622
- [6]Arntz A, Jacob GA, Lee CW, et al. Effectiveness of Predominantly Group Schema Therapy and Combined Individual and Group Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial JAMA Psychiatry, 2022.PMID 35234828
- [7]Assmann N, Schaich A, Arntz A, et al. The Effectiveness of Dialectical Behavior Therapy Compared to Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial Psychother Psychosom, 2024.PMID 38986457
- [8]Cristea IA, Gentili C, Cotet CD, et al. Efficacy of Psychotherapies for Borderline Personality Disorder: A Systematic Review and Meta-analysis JAMA Psychiatry, 2017.PMID 28249086