Behavioral Therapy
Adult behavioral psychotherapy focuses on influencing thoughts, attitudes toward feelings, and behavior. This therapeutic approach is characterized by its problem, goal and action orientation.
At the beginning of therapy, a problem analysis takes place in which individual predisposing, triggering, and maintaining problem conditions are identified. For successful psychotherapy, it is important to motivate the patient and to establish a trusting patient-therapist relationship. In the next step, the therapy goals are developed together and finally worked on with special therapy procedures.
Classic procedures include psychoeducation, systematic desensitization and exposure. In psychoeducation, the patient should develop a good understanding of his illness and its treatment at the beginning of therapy.
During systematic desensitization, the patient has to imagine certain anxiety situations. He starts with the situation that triggers the least anxiety. The goal is to combine the anxiety-provoking situation with relaxation until the patient’s anxiety decreases in his imagination. Thanks to this approach, the patient should gradually get used to the fear and perceive it as non-threatening.
During exposure, the patient must confront himself with fear-inducing stimuli. One can start either with the most severe or with the lightest stimuli. The goal is fear habituation. Exposure is based on habituation. If one remains long enough in a fear-inducing situation, it gradually decreases by itself and loses its threatening nature. It is important to identify and reduce possible safety behaviors and avoidance on the part of the patient. As therapy progresses, the patient should face anxiety-provoking situations outside the practice alone.
Schema Therapy
Schema therapy was developed as a further development of the cognitive-behavioral therapy approach by Jeffrey Young. The focus of schema therapy is the patient’s emotional experience. Biographical aspects are integrated to a greater extent than in cognitive-behavioral therapy, and current problems are traced back to unfavorable developmental conditions. In addition, the therapy relationship plays a particularly important role, in which limited parental care and changed interaction patterns are to be realized.
The basic concept of schema therapy builds on early maladaptive schemas. These are dysfunctional patterns that developed during childhood and include thoughts, feelings, perceptions, and interpersonal actions. When such an existing schema is activated, intense feelings from earlier are relived. They cause adults to reactivate the destructive experiences from childhood.
The schemas are a constant companion and although they cause suffering, they also give a pleasant feeling of familiarity. That is why they are so difficult to discard. The maladaptive schemas stem from five schema domains that represent basic emotional human needs. When one of these needs was not met in childhood, a matching schema emerges.
Responses to schema activation are three coping styles: enduring, avoiding, and overcompensating. These strategies represent dysfunctional coping with the schemas and contribute to their maintenance. The same can produce different schemas in patients in the form of different behavioral and experiential patterns.
For this reason, schema modes were developed to denote emotional and experiential states triggered by schemas. The modes can be divided, for example, into “child modes,” “dysfunctional parent modes,” “dysfunctional coping modes,” and the “healthy adult” mode.
The goal of therapy is for the patient to better recognize, perceive, and meet his or her own needs. Needs play a major role in therapy and therapeutic interventions are geared towards them.
Fundamental in the treatment is the strengthening of the mode of the “healthy adult”. In this way, even in the long term, the maladaptive schemas can be recognized and subsequently changed.
Patients must learn to cope with, come to terms with, and eventually abandon the dysfunctional modes. Since the modes are closely related to the patient’s reported problem, this also means that their symptomatology is worked on at the same time.
Psychological psychotherapist
Dipl. Psych. Malgorzata Wikiel-Adler
Psychotherapeutic practice
Sonnenstraße 3
86745 Hohenaltheim
Tel.: +49 (0)9088 – 920 78 89
Faks: +49 (0)9088 – 920 78 96
E-mail: praxis(at)wikiel-adler.de
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Consultation hour:
Monday: 06.00 – 07.00 pm
Friday: 09.00 – 10.00 am
