Case Example: A Clients’ Experience Using Secure Nest

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This case example was written to illustrate how Secure Nest could be used

This case example was written to illustrate how Secure Nest could be used to benefit clients when facing real-world challenges between sessions and to support therapists and clients in therapy sessions.

Sam presents to therapy with anxiety related to feelings of pressure at work, a history of relationships with untrustworthy or emotionally disconnected people, loneliness and a sense of emptiness. Sam’s core needs are to connect to her feelings and needs, to feel loved, accepted just as she is and to develop safe and trusting connections with those who are emotionally available.

In the first phase of therapy Sam and her therapist developed an individualised mode model on Secure Nest, supporting Sam to become familiar with the mode model (My Modes). The templates and examples provide structure and support for her therapist.

The language in My Modes reflects Sam’s personal experience of the modes. Ease of access to the mode model encourages processing between sessions. Sam chose individual names and images to fit her personal experience of the modes.

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In this first phase of therapy Sam is able to increase awareness of her modes between sessions by:

Logging in to Secure Nest when experiencing current situations which activate her schemas and trigger modes.

By accessing the mode model between sessions Sam starts to make links between current difficulties and her modes, internalising the information, speaking in mode terms and strengthening her Healthy Adult.

In this first phase of therapy it is difficult for Sam to identify her modes by herself, especially when feeling overwhelmed. Therefore her therapist has entered individualised information, including what her modes could be saying to encourage Sam to slow the process down and re-connect with her thought processes (Identify My Modes) .

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Sam experiences success early in therapy by identifying that her Demanding / Punitive mode is triggered and now feels empowered to work on negative internalised messages.

Sam listens to a recording where her therapist sends the Demanding / Punitive mode away, listens to a flashcard prepared together with her therapist and reads about universal core emotional needs. Sam is able to re-connect with the Healthy Adult / good parent side with this strong support to change negative messages.

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However, at other times Sam experiences periods of dissociation between sessions and she feels disconnected from her feelings and needs, disconnected from others and she loses track of time. To help with this, Sam is sent a friendly reminder email (appointment set by her therapist) from Secure Nest to try and check her calendar so that she can feel connected to her therapist even when they are not together.

Sam is able to tick a check box when viewing her calendar and she now feels empowered to try a suggested homework exercise which is also in the calendar.

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Sam tries a suggested homework exercise to monitor her modes. Writing responses down can be a demand from her Punitive / Demanding mode and she chooses to audio-record her response. She rates her level of distress before and after the exercise and see’s that it is possible to reduce the intensity of her distress, even when her modes are strong. The rating provides immediate feedback to Sam. Sam writes feedback about the exercise and discloses information which she would feel unable to share in session.

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Sam noticed that perhaps her Punitive / Demanding mode was triggered by writing down her response to the homework exercise. She completes a mode diary to understand this further. Each text box provides an example, which helps her know what is expected. Her therapist has written clues about which modes could be active and information linked to childhood experiences which supports Sam when completing the diary. This helps Sam to move away from the trigger event to the deeper patterns or themes.

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Sam receives an email from Secure Nest asking her to try and rate the strength of her modes (entered as a calendar entry).

At this early phase of therapy the graphs can be accessed from the therapists’ perspective because the focus is on building awareness of mode dynamics rather than results, which could trigger the Punitive / Demanding mode.

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Sam is at work reflecting on her mode dynamics but she would like to look at her therapy goals. Sam has her mobile phone and accesses Secure Nest, the individualised goal icon captures her eye and she clicks on this to access her goals.

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Sam receives a note from her therapist asking her to consider changing her profile colour. Sam feels like the application grows when she changes her profile colour. Sam is outer-directed and her outer-environment really dictates her inner life. She notices this change and identifies how her Vulnerable Child feels.

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Sam sees a picture of her therapist which reminds her that she is not alone, they are connected and working together.

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We hope this provides some insight into the way Secure Nest can be used in the therapy process.

The Secure Nest Team

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Secure Nest provides personalised online therapy tools designed specifically for schema therapy. Read more here or register for your free trial.

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