Schema Therapy for Patients with Bipolar Disorder: Theoretical Framework and Application

Abstract

Marie Ociskova,1 Jan Prasko,1– 3 Krystof Kantor,1 Frantisek Hodny,1 Pavel Kasyanik,4 Michaela Holubova,5,6 Jakub Vanek,1 Milos Slepecky,2 Vlastimil Nesnidal,1 Kamila Minarikova Belohradova1 1Department of Psychiatry, University Hospital Olomouc, Faculty of Medicine, Palacky University in Olomouc, Olomouc, The Czech Republic; 2Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic; 3Department of Psychotherapy, Institute for Postgraduate Training in Health Care, Prague, The Czech Republic; 4Schema Therapy Institute, St. Petersburg, Russia; 5Department of Pedagogy and Psychology, Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec, The Czech Republic; 6Department of Psychiatry, Regional Hospital Liberec, Liberec, The Czech RepublicCorrespondence: Jan Prasko Email [email protected]: Bipolar disorder (BD) is a severe mood disorder characterized by episodes of depression and hypomania or mania. Despite its primarily biological roots, the onset and course of the disorder have also been related to psychosocial factors such as early adverse experiences and related maladaptive schemas. Several researchers proposed a schema therapeutic model to treat patients with BD. In this paper, we further develop the theoretical model and elaborate on seven elements that were found effective in the psychosocial interventions with individuals with BD: monitoring mood and early symptoms of relapse, recognizing and management of stressful situations and interpersonal conflicts, creating a relapse prevention plan, stabilizing the sleep/wake cycle and daily routine, encouraging the use of medication, and reducing self-stigma and substance use. Apart from that, we describe the elements of the schema work with patients who suffer from BD. Illustrative clinical cases accompany the theoretical framework. The research of the schema therapy with patients with severe mental illnesses has only recently started developing. The presented paper also aims to encourage further research in this area and highlight potentially beneficial research goals.Keywords: bipolar disorder, schema therapy, early adverse experiences, imagery rescripting, relapse prevention, self-stigma

Keywords

• bipolar disorder / schema therapy / early adverse experiences / imagery rescripting / relapse prevention / self-stigma