Act Nerv Super Rediviva 2014; 56(1–2): 24–31 ORIGINAL ARTICLE Activitas Nervosa Superior Rediviva Volume 56 No. 1–2 2014 This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially. Schema therapy for CBT therapists who treat borderline patients Jana Vyskocilov a 1 , Jan Prasko 2 , Zuzana Sedlackova 3 , Marie Ociskova 2,3 , Ales Grambal 2 1 Faculty of Humanities, Charles University Prague, Czech Republic; 2 Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc, Czech Republic; 3 Faculty of Philosophy, Department of Psychology, Palacky University Olomouc, Czech Republic. Correspondence to: Jan Prasko, Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc, Czech Republic; e-mail: praskojan@seznam.cz Submitted: 2014-05-20 Accepted: 2014-06-11 Published online: 2014-07-28 Key words: schema therapy; borderline personality disorder; cognitive behavioral therapy Act Nerv Super Rediviva 2014; 56(1–2): 24–31 ANSR561214A02 © 2014 Act Nerv Super Rediviva Abstract Although treatment of BPD is complicated, CBT therapists can learn schema therapy (ST) principles and strategies used as an additional tool in the therapy. ST originally began as an extension of Beck’s cognitive therapy model and has developed into an unique integrative treatment for the personality disorders. According to the ST principles, schemas provide in-depth understanding of personality disorders. People perceive their own self, others and world in the lenses of their schemas. A schema is an extremely stable, constant pattern which developed during childhood or adolescence and now is elaborated in individual´s life. ST also devotes considerable attention to modes, the predominant emotions, schemas, and coping reactions used by an individual at a particular time. The aim of the therapy is to engage in schema healing processes. These methods are intended to reduce the early mal- adaptive schemas and coping styles, and build up more adaptive and healthy approaches. A conceptualization is usually created early in the treatment. The history of the schemas, modes and coping strategies are systematically discussed, their origins explored and linked to current problems, and the opportunity of modifying is explored. In treatment phase, the therapist flexibly uses cognitive, emotional/experiential, behavioral, and relational/ interpersonal strategies to change schemas and maladaptive coping styles. The therapeutic relationship is also an important part of the healing process The relationship is an area in which behaviors modes and schemas can be noticed, assessed and modified. It is also used as mediator for a “corrective emotional experience”. The therapist behaves in ways that supply the unmet early needs of the patient. This connection to the childhood is mir- rored in the label of this particular stance called “limited reparenting”. The change of the schemas is impossible without the well-established therapeutic relationship. Introduction Patients suffering from borderline personality disorder (BPD) are known as difficult to work with. They show high affective instability, a proneness towards aggres- sive, impulsive, self-mutilating, and suicidal behavior, dissociation, unstable identity, conflicting interper- sonal relations, chaotic lifestyle, high comorbidity levels, and low treatment efficacy (Latalova & Prasko 2010; Prasko et al 2010b; Vyskocilova et al 2011a). The etiology of BPD is best explained as a combination of genetic, neurobiological vulnerability combined with a childhood trauma, abuse or neglect (Hunt 2007). This combination might in some individuals lead to dys- regulated emotions, distorted cognitions, social skills deficits, and insufficient adaptive coping strategies.