What is Schema Therapy?

Schema therapy tackles problems more complicated than those treated by CBT. These are often chronic psychological symptoms and are related to maladaptive personal beliefs or schemas (such as the belief that one is unlovable or is convinced of eventually being abandoned by others). The purpose of this therapy is to correct maladaptive beliefs and their associated coping strategies. Once treated, the patient’s perspective is healthier, behavior is more adaptive, and an individual’s needs are more likely to be met.

How does it work?

Schema therapy incorporates strategies from cognitive therapy, object relations, experiential techniques, and behavioral therapies. Schemata (basic beliefs) are diagnosed with the use of screening forms and via imagery techniques. Once schemata are identified a psycho-educational approach is provided wherein symptoms are explained to the patient, in terms of these schemas. Next, cognitive strategies are employed. For example, if someone had a ‘defectiveness’ schema (belief of being unlovable or unworthy of love) we have that person, consciously, minimize his supposed ‘defects’ and maximize his assets. This would be useful as an ongoing process. Next, an experiential technique is employed wherein the patient would address one or both parents (in imagination only) explaining what difficulties they have contributed to and the consequences for the patient; patients also describe what it is they had wanted from their parents as children. Throughout treatment, the therapist’s behavior is tailored to the needs of the patient – the therapist may be called upon to provide what is referred to as ‘limited re-parenting’ – meaning, meeting some of the patients needs, to the degree possible within the therapeutic setting.

How does a schema arise?

A schema may arise from the thwarting of the very basic needs of children (such as the need to be nurtured: TLC, listening, understanding, good advice). When early needs are not met, the individual has a distorted picture of reality. As an adult, that individual’s attitudes, emotions, coping strategies are more likely to be dysfunctional – as a result needs are less likely to be met. For example, someone with an emotional deprivation schema (due to insufficient nurturing) might think that they will never receive the caring that they desire. In order to cope with this, that patient might actually avoid emotional attachments, pick critical partners, or become demanding of affection from others. These coping strategies may stand in the way of the individual having his or her needs met. The coping strategies must also be altered.

What are core needs and coping strategies?

There are 18 basic needs that children have (some are more important than others). They are divided into several groups, such as: connection and rejection; impaired limits; other-directedness; and 2 others. There are 3 ways that an individual may cope with unmet needs: surrender (giving up); avoidance; and overcompensation. For example, a patient using surrender with a ‘defectiveness’ schema might put himself down or even pick critical friends or mates. Therefore, schema therapy treats psychological problems arising from the above that may also contribute to: chronic anxiety or depressive disorders, personality disorders, and interpersonal issues.

Can I read more about Schema Therapy?

You may be interested in reading, Re-inventing Your Life, a patient centered book written by Jeff Young, PhD. It describes most of schemata (he refers to them as “life-traps”), how they developed, and how they are changed.

Schema Therapy Link

Schema Therapy Institute