What is schema therapy?

Dr. Jeffrey Young began developing schema therapy in the mid-1980s, when he found that traditional therapies, such as cognitive behavioural therapy were not helpful for people with chronic characteristic problems like personality disorders. These clients tend not to respond to traditional treatments or relapse quickly afterwards. He defined the term schema as a life-changing pattern of negative behaviour that a person repeats throughout their adult life. 

Schema therapy incorporates elements of cognitive behavioural therapy, attachment theory and a number of other approaches to explore emotions and methods of maladaptive coping as the origin of mental health problems. Schema therapists help clients change their entrenched, self-destructive life patterns (schemas) through cognitive, behavioural and emotion-focused techniques.

Schema therapy

How does schema therapy work?

With regard to strategies for regulating emotions, clients receive intensive psycho-education on schemas, coping modes and the basic needs in the normal development of children. After initial work with the therapist, the client works on ways to process emotions related to their relevant schemas in order to change unhealthy coping styles resulting from erroneous or unhealthy schemas that cause symptoms of mental health disorders.  

The original goal of the schema-focused therapy is to identify the schemas relevant to clients and to link them to past events and current symptoms. Since it is difficult or impossible for clients to change their behaviour at the beginning of therapy due to a lack of adaptive schema strategies, the focus of therapy is on preparation with experiential techniques. Therapy techniques including imaginary exercises and chair work are used, which can activate a high degree of emotional change in the individual.  

schema therapy

Change can be difficult

During treatment, the individual learns to recognize the thought patterns associated with early maladaptive schemas. Such clarity can be achieved by working with the client to identify their schemas and become aware of childhood memories, emotions, sensations, cognitions and the coping styles that were developed as a result. If the basic emotional needs of the patients are not met, infantile schemas, coping styles and modes develop.  

Change requires breaking long-standing emotional, cognitive, and behavioural patterns, which means changing dysfunctional schemas, coping strategies, and modes. Although it is not always easy, schema healing involves changing behaviour and replacing mismatched coping styles with more effective and less harmful ones. Maladaptive coping styles have been helpful to clients in avoiding situations related to the schemas, but they are turning out ineffective in the long run.