Body-oriented psychological therapy for schizophrenia

Domain IV · Body-oriented psychotherapy · Frank Röhricht · 2000

What it is

BPT is a manualised outpatient group programme, not a separate school of therapy. It brings together the three roots that Röhricht sees in body-oriented psychotherapy:

Format

• Format (NESS version).
• 20 group sessions, 90 minutes each, twice a week on non-consecutive days, over 10 weeks.

Who practises it, and how they are trained or regulated

• NESS used therapists accredited by the Association of Dance Movement Psychotherapy (ADMP), with an extra 2-day training in the manual. Martin et al. used a 3-day workshop with Röhricht and Papadopoulos.
• Version followed: Frank Röhricht's manualised group body-oriented psychological therapy (BPT; called body psychotherapy in the NESS reports) for chronic schizophrenia with predominant negative symptoms, as delivered in the UK NESS trial: 20 group sessions of 90 minutes, twice weekly on non-consecutive days over 10 weeks. The NESS manual is an updated version of the one used in the 2006 exploratory trial (Röhricht &…
• These non-verbal methods are combined with insight-oriented verbal reflection. In the NESS trial it was delivered by accredited dance movement psychotherapists.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Fears about the body that could become part of a delusion, a history of sexual trauma, and hostility toward groups. These mean you should plan adaptations before session 1.
• Overstimulation from noise: lower the volume, shorten turns. Collage images about weight or body shape: no comments on bodies, keep to the member's own word. It is working when members play…
• The same few members dominating: use rounds. Abstract or delusional elaboration: gently bring it back to sensation. It is working when there is a richer emotional vocabulary, more spontaneous…
• Long silences and members who say "nothing" or "don't know". Accept a number or a gesture instead. It is working when, over time, people give more differentiated answers, add a body location, or…
• Paranoid discomfort with eye contact: allow looking at hands or shoulders. Ideas of being copied or mocked: explain the game first and keep roles clear. Pairs who drift into chaotic or very fast…

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.