Personality disorder patients' perspectives on the introduction of imagery within schema therapy: A qualitative study of patients' experiences

A qualitative study was done on patients' perspectives on the first phases of imagery work in the context of schema therapy (ST) for personality disorders. Patients participated in a multi-center randomized controlled study of the effectiveness of ST. Patients' experiences and opinions were collected with semistructured in-depth interviews at the time when they were still in the early phases of treatment. The interviews were analyzed using a thematic analysis. For validation, a so-called member check was completed, in which participants could indicate whether they agreed or could correct the transcripts and the conclusions we drew from their interviews. We concentrated on the first imagery techniques that are used as preparation for imagery rescripting; that is, diagnostic imagery and imagery of a safe place. We compared the experiences reported by the patients with Young, Klosko, and Weishaar's (2003) ST manual. The results show that early imagery techniques in ST are considered a valuable method. However, patients emphasize that more attention should be paid to the emotional impact of this specific technique. They report lacking information, communication, and support during the initial phases of imagery work. Furthermore, patients mention that the duration of the imagery exercises is unpredictable; this creates feelings of uncertainty and fear. These results give essential information for protocol adjustments for the use of early imagery techniques and for the implementation of ST. (PsycINFO Database Record (c) 2011 APA, all rights reserved) (journal abstract