Schema Therapy and It's Role in Treating Chronic & Entrenched Psychological Disorders

A cartoon image of a psychologist and client using Schema Therapy.

What is Schema Therapy?

Schema therapy is an integrative treatment approach that is based upon cognitive-behavioural theoretical constructs. However, schema therapy also draws upon attachment, Gestalt, object relations, constructivist, and psychoanalytic frameworks to form its theoretical framework. Schema therapy was developed as a method of treating clients who had not responded to traditional cognitive behavioural treatment, such as individuals experiencing personality disorders and characterological issues. As such, schema therapy is a suitable treatment model for clients who are experiencing chronic psychological disorders that may be considered treatment resistant.

Schemas are enduring and stable maladaptive patterns that develop during childhood or adolescence, and are then perpetuated throughout the individual's life. Schemas impact a person’s self-concept, how they understand what has happened to them, and their perception of the world. Schemas often develop in response to a person's needs not being met during their early life, with the same schemas preventing these needs from being fulfilled during adulthood. Schemas result in people behaving in ways that are not only self-defeating, but also self-destructive. A large number of schemas have been identified, including Abandonment/Instability, Mistrust/Abuse, Defectiveness/Shame and Unrelenting Standards.

Techniques Used in Schema Therapy

The aim of schema therapy is to heal an individual’s schemas. Treatment aims to blend cognitive, experiential,

behavioural, and interpersonal techniques to assist clients in healing their schemas and replacing the unhelpful methods that they use to cope with their schemas with healthier behaviours.

Cognitive Strategies

Used to increase clients’ intellectual awareness of their schemas, and help them understand that the schema is not wholly true.

Experiential Strategies

Aim to target the schema on an affective level and provide the client with an emotional understanding of their schemas. Techniques include imagery rescripting and writing letters to parents.

Behavioural Strategies

Involve replacing schema-driven behavioural patterns with more adaptive patterns of behaviour through specific behavioural assignments.

Schema therapy also relies upon the therapeutic relationship to create change for clients. The therapeutic stance involves utilising:

Empathic confrontation

Expressing understanding of the client and their schemas while simultaneously confronting the need for change.

Limited reparenting

Providing clients with what they needed from their parents throughout their early development within the appropriate boundaries of therapy.

Find out more on our Schema Therapy page.

Image: https://schematherapyservices.co.uk/ Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner's guide. Guilford Press