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Schema Informed Formulation in Probation: The merits and challenges of
trauma informed thinking
Dr Felicity Nichols
Clinical Psychologist
Lincolnshire Offender Personality Disorder Pathway
Overview
• The Pathway and the probation context
• Schema Theory
• The Approved Premise– our input
– its reception
• The Challenges
• The Merits
• Reflections
Early Identification
Workforce Development
Sentence/Pathway Planning
Offender Management
Approved Premise
• 100% Screening
• KUF Awareness Training
• Bespoke Mandatory Training
• 3 Tiered Formulation System
• Ongoing case consultation
• Cases held within the team
• Formulation work
• Case consultation
• Enabling Environments
The PD Pathway
Probation Context
Austerity
Transforming Rehabilitation
E3
PD Pathway
Integrative Model
Early Maladaptive
Schemas
Schema Modes
• Developed by Dr Jeffrey Young
• Draws upon CBT, Gestalt, Psychodynamic, Interpersonal, Attachment
• Increasing evidence base
• Define thoughts and behaviours
• Develop throughout childhood
• Significantly dysfunctional
• Enduring Personality Traits
• Dominate an individuals presentation in the moment
• Individuals ‘flip’ between modes
• Maladaptive way to protect self
Schema Theoretical Underpinning
Core Childhood
Needs
Capital ‘T’ Trauma
Lower case ‘t’ trauma
Early Maladaptive
Schema
Persistent Pattern
Memories, Feelings & Thoughts
Bodily Sensations &
Physical Reactions
Dysfunctional and Unhelpful
Template of Self, World &
Other
Early Maladaptive Schema
Secure Attachments
to Others
Independence, Competence
& Sense of Self
Realistic Limits & Self
Control
Spontaneity & Play
Freedom to Express Valid
Needs and Emotions
Toxic Frustration of Needs
Victimization and Trauma
Too Much of a Good Thing
Selective Identification and Internalization with Others
Schema Informed Working
Behavioural strategies (including
offending) understood as mechanism for meeting unmet
needs from childhood
Uses the relationship as primary vehicle for
change
Emphasis on impact of childhood experience
The Set Up
• The House on the Hill
• The ‘Cast’ of Characters
• Trauma at the Hostel
• A ‘PIPE dream’
Naming the Elephant (Amongst other things…)
• Resident ‘Mode formulation’
• Consultation/ Supervision
• Supporting Work Towards EE
• Reflective Practice
• Intervention
• Tea!
Vulnerable Little BenFeel sad
Feel unloved
Feel uncared for
Feel scared that people will leave or hurt me
Angry Child
BenNo one will look out for
me
I’m going to do what I
want
It's not fair
Detached Protector
Ben“It’s fine” / “I’m fine”
Drug use to ‘cut off and cope’
Push things to one side
Bully-Attack BenLash out
Attack others to keep them close
Compliant
Surrender BenGives in to the will of others
Agrees with / does what others
think
Healthy Adult Ben“I want to be a good Dad”
Stopping self doing things sometimes
because I know it won’t help
“I’m responsible for my own actions
and for changing them”
Critical Parent“I should be better”
“I keep getting it wrong”
“I’m just like my Dad”
Likely Schemas
Abandonment / Rejection
Mistrust / Abuse
Defectiveness / Shame
Dependence / Incompetence
Insufficient self-controlCan’t tolerate this so switches to either...
When this no longer works or the situation
cannot be controlled switches to...
WHAT TO DO:
•Provide a consistent response/ message
•Recognise that sometimes it feels easier to do
what you think others want but that this is
frustrating
•Ask about alternative options to respond to the
situation
•Say “I wonder if you are trying to do what you
think I want you to do rather than what you want
because you are worried about what I might do”
WHAT TO DO:
•Be clear and succinct in providing information
•Be consistent
•Recognise that it seems frustrating, tough, things feel a
bit overwhelming...
•Reassure that you are there to listen
WHAT TO DO:•Don’t provide lots of
information•Say “this is really hard for
you”•Recognise that he is trying not
to think about things•Discuss alternative coping
strategies
WHAT TO DO:
•Hold the
boundaries
where possible
•Recognise how
angry/frustrated
he feels
WHAT TO DO:
•Reassure that you are there
trying to help
•Recognise that it may feel like he
is alone / uncared for
•Provide rationale for the decision
/ situation
You may feel verbally attacked or
intimidated, angry, or anxious.
Paranoid Over-
Controller BenControlling in relationships
Invites others to behave in the
way he expects them to
Impression management
You may start to think about other
things, lose your trail of thought, or
feel tired/ start yawning
If you don’t feel
threatened
The Plan...Referral to mental health team
Access the gym
Warning signs for staff – lots of time on my
own – ask me if I want to talk
Naming the Elephant (Amongst other things…)
• Resident ‘Mode formulation’
• Consultation/ Supervision
• Supporting Work Towards EE
• Reflective Practice
• Intervention
• Tea!
“It’s not ok to make people cry”
Stop making me think!
• “Pink and Fluffy”
• “Our job is Public Protection”
• “I can’t do that – they might go out and hurt someone and it will be my fault”
Help me think more!
• “This makes so much sense”
• “It really works”
• “It’s great having you on hand to help”
• “We need to work together”
So who is the client?!
Behavioural strategies understood as
mechanism for meeting unmet needs
Uses the relationship as primary vehicle for
change
Emphasis on impact of previous
experiences
Staff / System Formulation
‘Angry Child Mode’It’s not fair
We aren’t being listened to
It’s not our responsibility / job
It’s not all just about the residents
‘Vulnerable Child Mode’
Not listened to
Undervalued
‘Dumped on’
Unsupported
Unsafe
Punitive ParentThe pull to rubbish and blame self/
others
Detached Protector ModeNon-engagement
Avoid leaving the office
Interactions through the ‘hatch’
Not communicating or recording information
Early ExperiencesHighly anxious
Incidents in the hostel
Rumours and hearsay
No Supervision
Shift patterns
Upheaval and change – uncertainty about jobs
Paranoid Over-Controller
ModeConvinced it is all going to go wrong
Looking out for threat and wrong-doing
Consistent e-mailing/ phone calls if someone
‘needs to be recalled’
Healthy Adult
Pockets / moments of positive
engagement and thought
Likely Schemas
Emotional Deprivation
Mistrust / Abuse
Punitiveness
Challenges
• A state of ‘unprecedented change’ – flux
• Lack of safety & management
• Not dealing with history and trauma in the staff team
• ‘Lacks victim empathy’
• Austerity
• I’m not a Psychologist
• Scapegoating
Merits
• Offers a non-stigmatising frame to begin to grapple with painful and “brutalising” material
• Meeting the need vs dependence
• Shifts in thinking
• Shifts in practice
• Pockets of thought
• Impact for residents
Ardino (2014)
“Recovery cannot occur in isolation. It can take place only within the context of relationships characterised by belief
in persuasion rather than coercion, ideas rather than force, and mutuality rather then authoritarian control –precisely the beliefs that were shattered by the original
attachment relationships”
“A profound cultural shift in which clients and their behaviours are viewed differently, staff respond
differently…an understanding of clients and their symptoms in the context of their life experiences and
history”
Reflections• Can we ever really deliver trauma
informed care without considering the ‘brutalising’ impact of the work on staff?
• Do we have permission to do this work?
• How often do we play into the ‘false dichotomy’?
• If the first step in trauma work is stabilization how can we effectively support staff teams in ever-changing climates?
• Is there a false dichotomy perpetuated by ‘the system’?
• How do we stay mindful of the impact on ourselves?
Containing the Container
• Bion – Container Contained
• Stokoe – Healthy Team
• Karpman – Drama Triangle
• Bloom – Sanctuary Model
• Searles – Parallel Processes
• Maslow – Hierarchy of Need
Questions