Schema Therapy With Older Adults
- A.C. VidelerA.C. VidelerPersonaCura, GGz Breburg and School of Social and Behavioral Sciences, Tilburg University
Schema therapy has evolved since the late 1980s as an efficacious and increasingly widely used psychotherapeutic treatment for personality disorders and many other complex disorders that correlate with underlying maladaptive schemas. Only recently, attention among clinical geropsychologists has been growing for the application of schema therapy in older adults. Schema therapy is very feasible for both therapists and older patients. Schema therapy is an integrative psychotherapy, which draws on the cognitive-behavioral, attachment, psychodynamic, and emotion-focused traditions. In this treatment model, early maladaptive schemas are considered core elements of persistent and pervasive psychopathology, including personality disorders. The goal of treatment is to decrease the impact of maladaptive schemas and to replace negative coping responses and maladaptive schema modes with more healthy alternatives so that patients succeed in getting their core emotional needs met. The emerging attention for schema therapy in older adults is in line with the increased attention for personality disorders in later life, and also with the maturing field of psychotherapy for older adults. The first scientific evidence for the feasibility and the effectiveness of schema therapy has recently been shown. Despite these developments, much work is still to be done. The question is whether schema theory, which was developed for adults in young and middle adulthood, equally applies to those in later life. Although the first tests of effectiveness of schema therapy in older adults are encouraging, age-specific adaptations of existing therapy protocols, both for individual and group schema therapy, are wanted. Furthermore, the research that has been conducted so far has focused on the young-old. Especially for the growing and highly complex group of oldest-old patients, the development of feasible and effective schema-based interventions is needed. Integrating age-specific moderators for change, such as wisdom enhancement, attitudes to aging, and integrating the action of positive schemas, deserves recommendation.