WHEN AND HOW TO DO LONGER TERM THERAPY ... WITHOUT FEELING GUILTY

Although short-term cognitive behavior therapies (CBT) are widely effe ctive, we have noticed that patients with personality disorders do not make sufficient progress with these treatments. We contend that optim al treatment can only be accomplished for these patients if it is modi fied to address the personality disorder. Schema-focused therapy (SFT) was developed by Young (1990) to specifically address the needs of th ese patients and combines cognitive, behavioral, interpersonal, and ex periential techniques in treatment. Compared to short-term cognitive t herapy (CT)(1), SFT emphasizes the therapeutic relationship as a vehic le of change, utilizes emotive techniques to address early issues and later life problems, involves less guided discovery, more active confr ontation of cognition and behavior patterns, and a greater concern wit h identifying and overcoming cognitive and behavioral avoidance. Final ly, because there is far more resistance to change, the course of trea tment is longer in SFT. Assessment, treatment strategies, and an illus trative case example will be provided in the present paper.