S2STP1-3 - Science to Practice
Tracks
Track 7
Innovation
| Saturday, June 1, 2024 |
| 11:15 AM - 12:45 PM |
Overview
Science to Practice
Details
Evaluation of the Efficacy Evidence of Schema Therapy and Research Agenda
Leonardo Wainer
Schema Therapy is an integrative psychotherapeutic model that was developed by Jeffrey Young as an advancement to cognitive-behavioral therapies (Edwards & Arntz, 2012; Young, Klosko, Weishaar, 2008). Schema Therapy was originally developed with the aim of working with individuals with chronic, refractory and personality disorders (Young et al., 2008). Currently, we can see studies that expand this initial focus, such as studies with eating disorders (McIntosh et al., 2016). The therapeutic model has, in recent years, gained greater popularity among clinicians and in trainings. The International Society of Schema Therapy (ISST) has more than 3000 members on five continents. As the approach gains notoriety, it becomes necessary to evaluate the effectiveness of the model and identify for which demands there is evidence where Schema Therapy can and cannot be used. The objective of this presentation is to evaluate most of the research about the effectiveness of the model in its quality and to point out future aims of research.
Personality disorders prescribing guide: how to address to comorbidities of our patients
Jorge Gustavo Azpiroz Filho
Personality disorders (PDs) have a prevalence in the general population of 7,8%, and clearly present one of the most important indications for schema therapy. However, like most mental disorders, the presence of comorbid diagnoses is common, with each of the PDs more frequently presenting certain profiles of associated diagnoses. Being clear about which psychopathologies to seek to identify, in addition to assisting in the most appropriate psychotherapeutic management, is also essential to know how to differentiate when the patient needs referral for evaluation of the use of psychotropic drugs and when the patient is only presenting maladaptive coping strategies.
Through a review of the literature, using the DSM-5TR to identify main comorbidities, this presentation aims to present tools to help the management of PDs patients through updated guidelines, and search for recent articles on pharmacological management of serious situations in PDs cases.
The Interplay between Schema Therapy and Ketamine for Treatment-Resistant Depression: Case studies
Melanie Babooram
Ketamine, a dissociative anaesthetic, has been used in surgery and pain management since the 1970’s. In the last 20 years, ketamine has received considerable attention by the psychiatric community for its antidepressant and psychedelic properties, and especially for the management of treatment-resistant depression (TRD). In 2021, the Australian Therapeutic Goods Administration (TGA) approved a ketamine intranasal spray known as Spravato for the management of TRD. Research studies examining the use of ketamine for managing TRD have shown some interesting results – rapidly improving mood to the point of remission, increasing positive emotion, reducing suicidal tendencies, and increasing both synaptic connectivity and neuroplasticity. Despite such promising findings, the antidepressant effects of ketamine as a standalone treatment for TRD are temporary (often only lasting from 24hrs to 7 days).
Psychotherapy has been put forward as a means of prolonging the effects of ketamine and make positive use of its dissociative elements. Formal research studies in this area are still in their infancy and have focused on Ketamine Assisted Therapy and the combination of ketamine and Cognitive Behavioural Therapy. However, childhood trauma and attachment injuries are often at the core of TRD, and more durable change requires trauma and attachment informed psychotherapy. Schema Therapy is applicable and effective for TRD, and is a promising candidate for combination with ketamine therapy. Despite this, no studies or case studies so far have examined the interplay between Schema Therapy (ST) and ketamine delivered specifically by subcutaneous means.
This presentation aims to address this gap by: 1) outlining the ketamine treatment protocol for TRD used at the Black Dog Institute in Sydney, Australia, 2) present two compelling case studies showing the positive outcomes achieved using ST and ST techniques with depressed clients receiving concurrent ketamine treatment at the Black Dog Institute, 3) emphasising the need for a biopsychosocial understanding, and treatment of TRD, and, as such, 4) propose an expanded role for ST in a multidisciplinary model of care for this condition.
Leonardo Wainer
Schema Therapy is an integrative psychotherapeutic model that was developed by Jeffrey Young as an advancement to cognitive-behavioral therapies (Edwards & Arntz, 2012; Young, Klosko, Weishaar, 2008). Schema Therapy was originally developed with the aim of working with individuals with chronic, refractory and personality disorders (Young et al., 2008). Currently, we can see studies that expand this initial focus, such as studies with eating disorders (McIntosh et al., 2016). The therapeutic model has, in recent years, gained greater popularity among clinicians and in trainings. The International Society of Schema Therapy (ISST) has more than 3000 members on five continents. As the approach gains notoriety, it becomes necessary to evaluate the effectiveness of the model and identify for which demands there is evidence where Schema Therapy can and cannot be used. The objective of this presentation is to evaluate most of the research about the effectiveness of the model in its quality and to point out future aims of research.
Personality disorders prescribing guide: how to address to comorbidities of our patients
Jorge Gustavo Azpiroz Filho
Personality disorders (PDs) have a prevalence in the general population of 7,8%, and clearly present one of the most important indications for schema therapy. However, like most mental disorders, the presence of comorbid diagnoses is common, with each of the PDs more frequently presenting certain profiles of associated diagnoses. Being clear about which psychopathologies to seek to identify, in addition to assisting in the most appropriate psychotherapeutic management, is also essential to know how to differentiate when the patient needs referral for evaluation of the use of psychotropic drugs and when the patient is only presenting maladaptive coping strategies.
Through a review of the literature, using the DSM-5TR to identify main comorbidities, this presentation aims to present tools to help the management of PDs patients through updated guidelines, and search for recent articles on pharmacological management of serious situations in PDs cases.
The Interplay between Schema Therapy and Ketamine for Treatment-Resistant Depression: Case studies
Melanie Babooram
Ketamine, a dissociative anaesthetic, has been used in surgery and pain management since the 1970’s. In the last 20 years, ketamine has received considerable attention by the psychiatric community for its antidepressant and psychedelic properties, and especially for the management of treatment-resistant depression (TRD). In 2021, the Australian Therapeutic Goods Administration (TGA) approved a ketamine intranasal spray known as Spravato for the management of TRD. Research studies examining the use of ketamine for managing TRD have shown some interesting results – rapidly improving mood to the point of remission, increasing positive emotion, reducing suicidal tendencies, and increasing both synaptic connectivity and neuroplasticity. Despite such promising findings, the antidepressant effects of ketamine as a standalone treatment for TRD are temporary (often only lasting from 24hrs to 7 days).
Psychotherapy has been put forward as a means of prolonging the effects of ketamine and make positive use of its dissociative elements. Formal research studies in this area are still in their infancy and have focused on Ketamine Assisted Therapy and the combination of ketamine and Cognitive Behavioural Therapy. However, childhood trauma and attachment injuries are often at the core of TRD, and more durable change requires trauma and attachment informed psychotherapy. Schema Therapy is applicable and effective for TRD, and is a promising candidate for combination with ketamine therapy. Despite this, no studies or case studies so far have examined the interplay between Schema Therapy (ST) and ketamine delivered specifically by subcutaneous means.
This presentation aims to address this gap by: 1) outlining the ketamine treatment protocol for TRD used at the Black Dog Institute in Sydney, Australia, 2) present two compelling case studies showing the positive outcomes achieved using ST and ST techniques with depressed clients receiving concurrent ketamine treatment at the Black Dog Institute, 3) emphasising the need for a biopsychosocial understanding, and treatment of TRD, and, as such, 4) propose an expanded role for ST in a multidisciplinary model of care for this condition.
Speaker
Dr Melanie Babooram
Clinical Psychologist
Black Dog Institute
The Interplay between Schema Therapy and Ketamine for Treatment-Resistant Depression: Case studies.
Biography
Dr Melanie Babooram is a Clinical Psychologist, currently practicing at the Black Dog Institute – a not-for-profit, mental health research organization – and private practice, in Sydney, Australia. Over the course of her career, Melanie has worked extensively in trauma, complex trauma and chronic pain management, and has practiced Schema Therapy in these areas since 2006. She is also a Board Approved Clinical Supervisor for early career psychologists. On the way, Melanie developed a keen interest in the interplay between psychology, neurobiology, psychiatry and medicine, as well as promoting Schema Therapy in interdisciplinary and multidisciplinary teams.
As part of the institute’s Clinical Services Team, Melanie regularly works with clients, is involved in teaching activities at the institute, and actively collaborates with the Black Dog Institute’s Neuromodulation (Neurostimulation) Clinic, who specialise in novel treatments for treatment-resistant depression, including ketamine.
Leonardo Wainer
Pontifícia Universidade Católica Do Rio Grande Do Sul
Evaluation of the Efficacy Evidence of Schema Therapy and Research Agenda
Biography
Leonardo is a psychologist, has a master's degree in Clinical Psychology and is a PhD fellow at the Pontifícia Universidade Católica do Rio Grande do Sul. He is also one of the directors of the Wainer Group. Leonardo is an Advanced Level Schema Therapist and Supervisor. Leonardo is the current Media Coordinator of International Society of Schema Therapy and is a founding member of the Brazilian Association of Schema Therapy.
