Treating Aggressive, Impulsive,

and Anti-Social Patterns

Schema Therapy with
Forensic Population

14-15 December 2014

SAVE THE DATE

David P. Bernstein, Ph.D.

Professor of Forensic Psychotherapy,
Maastricht University, The Netherlands

On Personality Disorders and Schema Therapy

Schema Therapy (Young, 1990, 2003) is an integrative form of therapy that combines cognitive, behavioral,
psychodynamic object relations, and humanistic/experiential approaches. Schema Therapy was developed
to treat patients with personality disorders. According to the DSM-V, personality disorder is defined as: ...
Only when personality traits are inflexible and maladaptive and cause significant functional impairment or
subjective distress do they constitute Personality Disorders...The Essential features of a personality disorder
is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the
individual's culture and is manifested in at least two of the following areas: cognition, affectivity,
interpersonal functioning, or impulse control.... Since PD is characterized by ego-syntonic and inflexible
traits, most of the patients may seems un-cooperative or leave the therapy early. Part of the patients will
even been involved in criminal activities and/or substance use disorder (SUD). According to research, about
up to 70% of people suffering from SUD will suffer from al least one PD. The behaviors will be
characterized by: verbal/physical violence, aggression, impulsivity, self-harm and manipulation. There is
good evidence for the effectiveness of Schema Therapy for Borderline Personality Disorder (Giesen-Bloo et
al., 2006; Farrell et al., 2009; Nadort et al., 2009) and Cluster C Personality Disorders (Bamelis et al., 2014).
Schema Therapy and Forensic Population
Bernstein and colleagues (2007) have adapted Schema Therapy for patients with aggressive and antisocial
problems, including psychopathic patients who are often viewed as untreatable. They are now engaged in
a randomized clinical trial at 7 forensic hospitals (TBS clinics) in The Netherlands to test the effectiveness
of this approach. The preliminary findings of this study show evidence of effectiveness, including for some
psychopathic patients (Bernstein et al, 2012). On the basis of these findings, the Netherlands
Erkenningscommissie (Recognition Commission) has recently certified Schema Therapy as an evidencebased treatment for forensic patients with personality disorders, the only treatment so far to have earned
this distinction.
Workshop Presenter:
David P. Bernstein, Ph.D. is Professor of Forensic Psychotherapy (endowed chair) at Maastricht University
and Forensic Psychiatric Center de Rooyse Wissel. He received his doctoral degree from New York
University in 1990. He joined the faculty of Maastricht University in 2004, where he now serves as Chair of
the Forensic Psychology Section in the Faculty of Psychology and Neuroscience. He is a former VicePresident of the International Society for Schema Therapy, and is a past President of the Association for
Research on Personality Disorders. His research spans a wide range of areas, including forensic
psychology, psychotherapy, personality disorders, childhood trauma, and addictions. He is an internationally
known expert on Schema Therapy, an integrative psychotherapy for personality disorders. He is the author
or co-author of more than 100 publications, including Schema Therapy: Distinctive Features (Rutledge
Press) and Schema Therapy: Working with Modes (DVD series; www.schematherapy.nl). His current
research focuses on developing, testing, and implementing innovative forms of therapy for forensic patients
with personality disorders. He gives many national and international workshops on Schema Therapy for
therapists working with forensic and addicted patients.

Workshops Goals
In this workshop, participants will learn the basics of the Schema Therapy approach as applied to a complex and
challenging group of patients: those with personality disorders, impulsivity, anger, aggression, and antisocial and
addictive behavior.
In this workshop, participants will be introduced to the central concept of schema modes, emotional states or
parts of the self that temporarily dominate a persons thoughts, feelings, and behavior. It is these moment-tomoment fluctuations that make individuals with personality disorders so challenging to work with. Schema
Therapy describes these emotional states using simple, non-judgmental language that is easy for patients and
staff to understand.
Our experience in forensic settings for adults and youth shows that patients and staff can readily learn to use the
mode language. This shared language takes conflict situations and turns them into learning opportunities, where
people with personality disorders can look at their maladaptive behavior in a more objective and constructive
way. Using lecture material, videos, live demonstrations, and exercises, participants will learn how to recognize
schema modes, and to use this concept to understand, and more effectively respond to, the challenging behavior
of these complex patients.
Goals for Day 1 of the workshop:
- Learn the Schema Therapy theoretical model as it is applied to forensic patients, with special emphasis on
schema modes.
- Learn to recognize modes and understand how they contribute to stuck points in therapy.
- Use Schema Therapy and mindfulness to get in touch with modes that are triggered in you by the modes of the
patient, and how to work with your own emotional reactions.
- Learn how to make a case conceptualization and treatment plan based on schema modes.
Goals of Day 2 of the workshop:
- Learn how to motivate and engage patients, using schema mode work.
- Learn how to work with patients emotional detachment.
- Learn how to use imagery rescripting to help patients reprocess painful experiences, such as childhood trauma.
- Learn how to work with anger and aggression.
Who Should Attend
Therapists such as psychiatrists, psychologists, social workers, criminologists, and psychotherapists who are in
contact with patients manifesting aggressive, manipulative, impulsive and violent behavior.
Preparation
Participants should be prepared to play the role of a patient with anger, impulsivity, or aggression problems
during the role play exercises. Ideally, the patient should be one with whom the therapist is working currently, or
in the recent past, or remembers quite well. Participants do not need to write up the case. However, they should
familiarize themselves with the main biographical details, and the central themes or issues of the case, and be
ready to briefly summarize the case (in 5 minutes).
Format
Demonstrations will be in English. However, participants should feel free to do the exercises in their own
language. Participants will do the exercises in pairs, with one participant playing the therapist and the other the
patient, and then switching roles. The trainer will circulate among the pairs to observe and give feedback.

14 December 2014
09:00 - 09:30 - Gathering and coffee
09:30 - 10:00 - Opening speeches
Dr. Boaz Lev - Associate Director General, the Ministry of Health
Dr. Yehuda Baruch - Hospital Director, the Abarbanel Mental Health Center
Prof. Eshkol Rafaeli - Director of Adult Clinical Training Program, Department of Psychology, Bar Ilan
University; the Israeli Institute of Schema Therapy
Mrs Miri Froimovich - Head of Clinical Criminologists, the Abarbanel Mental Health Center
10:00 - 11:00 - Introduction to Schema Therapy for impulsive, aggressive, and antisocial patients
11:00 - 11:15 - Break
11:15 - 12:15 Early maladaptive schemas, coping responses, and schema modes
12:15 - 13:00 Recognizing schema modes. Exercise #1: Which mode is it? Rating schema modes
with the Mode Observation Scale (MOS)
13:00 - 14:00 Lunch
14:00 - 15:00 Exercise #2: Therapists reactions to patients modes: A mindfulness approach
15:00 - 15:30 Schema mode stand-offs
15:30 - 16:00 - Break
16:00 - 17:00 Demonstration: Making a schema mode case conceptualization and treatment plan
17:00 - 17:30 Schema mode models
17:30 18:00 Wrap up: Day 1

15 December 2014
9:00 10:00 Motivating and engaging impulsive, aggressive, and antisocial patients; general
approach to schema mode work
10:00 10:15 Break
10:15 11:30 Demonstration and Exercise #1 Schema mode dialogue with the Detached Protector
mode
11:30 11:45 Break
11:45 13:00 Demonstration and Exercise #2 Protecting and reparenting the Vulnerable Child in
imagery
13:00 14:00 Lunch
14:00 15:15 - Demonstration and Exercise #3: Working with the Angry Child mode
15:15 15:45 - Break
15:45 16:45 Demonstration and Exercise #4: Limit setting with Bully and Attack mode
16:45 17:00 Wrap-up: Day 2

Registration
Until the 06/11/14

Until the 07/12/14

After the 07/12/14

First Day

500 NIS

550NIS

600 NIS

First & Second Day

850 NIS

1,000 NIS

1,200 NIS

Notes: Due to the experiential nature of the workshop' second day: 1/ the number of the workshops places is limited; 2/ attendance to the
workshop second day will be possible only to the participants who will attend to the workshops first day.
The prices include, coffee breaks, and lunches. A personal certificate from the International Society of Schema Therapy (ISST) confirming
your attendance at the two days workshop.
Cancellation until the 06/11/14 will be charged 50 NIS only. After that date, cancellation will be charged up to 50% the amount of the
reservation made.

Place
The workshop will take place at the Bar Ilan University on the 14 and 15 of December 2014, in the Gondas
conference room on the ground floor of the Leslie & Susan Gonda (Goldschmied) Brain Research Center (building
#901). The entry to the University is through Gate #5.
For Registration, please contact, Eychut Beshikum to:
Tel: 03- 5552784
Mail: office@eychut.org.il

Requirements:
No previous Schema Therapy experience is necessary.

Readings:
Bernstein, D., Arntz, A., & de Vos, M. (2007). Schema Focused Therapy in forensic settings: theoretical model
and recommendations for best clinical practice. International Journal of Forensic Mental Health, 6, 169-183.
Bernstein, D.P., Keulen-de Vos, M., Jonkers, P., de Jonge, E., & Arntz, A. (2013). Schema Therapy in forensic
settings. In van Vreeswijk, M. Broersen, J. & Nadort, M. (Eds.), Handbook of Schema Therapy. Routledge.

Also recommended:
Bernstein, D. (2014). Safe Path: An integrated, team-based approach for aggression, addiction, and antisocial
behavior. Unpublished Document.
Bernstein, D.P., Nijman, H., Karos, K., Keulen-de Vos, M., de Vogel, V., & Lucker, T. (2012). Schema Therapy for
forensic patients with personality disorders: Design and preliminary findings of multicenter randomized clinical
trial in the Netherlands. International Journal of Forensic Mental Health, 11, 312-324.
Chakhssi, F., Kersten, G., de Ruiter, C., & Bernstein, D.P. (2014, March 31). Treating the untreatable: A single
case study of a psychopathic patient treated with Schema Therapy. Psychotherapy. Advance online publication.
http://dx.doi.org/10.1037/a0035773
Keulen-de Vos, M., Bernstein, D.P., Vanstipelen, S., de Vogel, V., Lucker, T., Slaats, M., Hartkoorn, M., & Arntz, A.
(2014). Schema modes in the criminal and violent behavior of forensic cluster B personality disorder patients: A
retrospective and prospective study. Legal and Criminological Psychology, 1-21. DOI:10.1111/lcrp.12047
Rafaeli, E., Bernstein, D.P., & Young, J. (2011). Schema Therapy: Distinctive Features. London & New York:
Routledge.
van der Wijngaart, R., & Bernstein, D. (2011). Schema Therapy: Working with modes, 2nd Edition. 5 DVD boxed
series. www.schematherapy.nl

Handouts:
Mode Observation Scale (MOS) scoring form