Complex trauma is a condition that develops due to some form of abuse (physical, sexual or emotional) during childhood and/or adolescence. When individuals experience trauma in their formative years, the way in which the individual perceives the world may be affected and schemas may develop.
A schema is an extremely stable and enduring pattern that develops during childhood or adolescence (as a result of the trauma) and is elaborated on and reinforced throughout an individuals’ life. Schemas are important beliefs and feelings individual has about themselves, other people and the environment around them and are made up of cognitive, emotional and behavioural aspects.
When specific schemas (usually related to past negative experiences) are triggered in daily life, an individual may experience intense emotional states leading to dysfunctional coping styles. These coping styles which are designed to help the individual manage the feelings associated with the trigger may include dissociation, self-harm, substance abuse, emotional withdrawal/shutdown or avoidance.
Although helpful in the short term, these behaviours result in a self-perpetuating cycle of trigger and avoidance which prevents the individual from learning more adaptive coping strategies and the subsequent reprocessing of the trauma. Both these processes are vital for healing to occur and for individuals to live a life free of their triggers and past experiences. For individuals with complex trauma this “emotional rollercoaster” of trigger and coping can be exhausting, confusing and lonely and can result in the person feeling very alone in the world and misunderstood.
Schema therapy for complex trauma
The Schema Therapy Program offered at the Victoria Clinic aims to “slow down this emotional rollercoaster” by bringing people together who have had similar experiences. Through the program, the schema team are committed to creating a safe, contained environment where patients can explore and begin to understand the effects of their trauma on their current life and learn new ways to manage their symptoms so that they are not stuck in self-perpetuating patterns of behavior.
The program draws on cognitive, behavioural and experiential techniques and aims to addresses the following:
• How schemas have developed and how they relate to adult symptoms and problems of complex trauma.
• The emotional states and reactions related to complex trauma.
• Learn new ways of managing post-traumatic stress symptoms.
• Learn skills in managing important relationships and explore interpersonal functioning
• Develop healthier self-esteem by treating schema driven negative thoughts.
• Develop a distress management plan before leaving hospital and creating a plan for continuing treatment.
• Education on the development of complex trauma and the relevant schemas
• Emotional awareness training so patients can notice pre-crisis distress and have better understanding of their emotional experience and subsequent behavior
• Develop an effective individualized distress management plan
Size of therapy group
Each group will be limited to a minimum and maximum of 6 and 10 patients, respectively.
Daily structure during the program
Over the course of the inpatient stay, patients will be required to attend three one hour sessions of schema therapy. Each session consists of three discrete therapeutic modules.
Session one Welcome and Review (10.30 - 11:30):
Patients are welcomed and are given the opportunity to practice grounding techniques, discuss how they are feeling and engage in connection
activities. It is in this session where homework tasks will be reviewed and the goals of the day discussed. During this session, patients are encouraged to reflect on their night/day using schema principles and identify experiences in which they felt they managed well and experiences in which they struggled with. It is a supportive space, where patients can support and learn from one another.
Session Two Experiential Component (12.45 - 1.45):
After the first break, patients are then invited back into the therapeutic space and are asked to engage in an experiential activity that has been developed based on the themes of the week. There are a number of schema specific experiential activities that can be introduced in this portion of the day. This can include imagery exercises, mode dialogues and chair work.
Session Three Psycho-education and Skills building (2.30 - 3.30):
The behavioral and cognitive components of the group program are introduced after lunch. It is during this session that patients will be provided with psycho-education around a relevant theme or taught affect regulation skills/ behavioral interventions to manage any problematic
behavior. It should be noted that the material being presented in this session usually has a direct relationship to what has been discussed in the previous
Referral process
The Victoria Clinic (TVC) is a Private Psychiatric Hospital. As a result, clients who wish to be considered for the Inpatient Schema Program must have a psychiatric inpatient referral from their GP.
For clients who have an existing relationship with the hospital and who frequently see a Victoria Clinic accredited psychiatrist a TVC referral form.
Please note that GP referrals to private psychiatric facilities are valid for 12 months. Referrals need to be up to date in order for an admission to be considered.
The assessment process
The assessment process for The Schema Therapy Program for Complex Trauma is broken down into three phases:
Phase One:
Once a referral/expression of interest has been received, an assessment pack will be sent (either via email or mail) to the patient. Included in this assessment pack is a variety of questionnaires designed to gather background information about the patient’s presenting problems, their life history and associated schemas. The patient is asked to fill out the entire pack (to the best of their ability) and return the pack (either via email or mail) to The Victoria Clinic Wellness Centre.
Phase Two:
Once the completed pack has been received, a member of the schema team will contact the patient to organize a clinical assessment. This assessment will go for approximately 1- 2 hours and will involve structured interview as well as follow up questions based on the answers obtained from the previous paperwork. This session also provides an opportunity for patient’s to ask any questions they may have about the program as well as be educated about the structure of the program and program goals.
Phase Three:
Once the clinical assessment has been completed, a report will be written and presented to the schema team to determine suitability. Patients will be notified of the outcome of this meeting via phone and treatment options will be discussed.
Cost
Private health insurance is recommended. Clients will need to have top psychiatric and hospital cover for the program to be fully funded by their health insurance. If clients have basic cover we encourage them to make contact with their insurance company and discuss the possibility of upgrading their cover. On most occasions, health funds require clients to serve a two month wait period prior to an inpatient admission.
The Schema Inpatient Program may also be funded by other agencies such as Work cover. It should be noted however that this is assessed on an individual basis and may differ from case to case.
Self-funded clients are also welcome and if you require more information regarding this option please contact the hospital directly on 03 9526 0295.
Ongoing care post discharge
Upon completion of the four week inpatient cycle patients will meet with the schema team to discuss post discharge options:
• Schema Day Program at TVC
• Schema Graduate Booster Groups (inpatient)
• Individual Schema Therapy.
If you would like more information regarding the schema therapy program please contact us on: 03 9526 0295 or [email protected]
MALVERN RD
MALVERN RD
WILLIAM S RD
BENDIGO ST CHAPEL
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CHAPEL ST
SURREY
RD MOTHERWELL ST
SIMMONS ST
SIMMONS CT
BRA Y ST
LITTLE CHAPEL ST
PRINCESS CL
PRINCESS ST
MURRAY ST
MACKAY ST CLARKE ST FRANC
IS ST
LEILA ST BELLA ST
ESSEX
ST
YORK
ST
KING ST
CECIL PL
ANCHOR PL CLIF TON ST
MOUNT ST
REGENT ST
BANGS ST
BARNS BUR Y RD
LUXTON RD
JOY ST HOWITT ST MCKILLOP ST HOBSON CROM ST
WELL RD
324 Malvern Road Prahran VIC 3181
Phone: 03 9526 0200 | Fax: 03 9526 0222 www.thevictoriaclinic.com.au
