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Schema Therapy

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Schema therapy is an innovative psychological therapy developed by Dr. Jeffrey Young for individuals suffering from emotional and behavioural difficulties (for example difficulty in coping or emotional regulation), character or personality difficulties or disorders, chronic depression and other long-standing interpersonal difficulties (Young et al, 2003). Schema therapy integrates elements of cognitive-behavioural therapy, object relations and gestalt therapy into one unified, systematic approach to treatment.

Often short-term CBT is enough to help people overcome emotional problems, especially depression and anxiety. Numerous clinical trials have demonstrated this. For people though who have long-standing difficulties with depression and anxiety or in relationships with others, short-term CBT might not be effective and hence the development of schema-focused therapy.

A schema is an extremely stable and enduring pattern of viewing the world around us that develops during childhood and is elaborated throughout an individual’s life. Schemas are important beliefs and feelings about oneself and the environment which the individual accepts without question. They are self-perpetuating, and are very resistant to change. For instance, children who develop a schema that they are incompetent rarely challenge this belief, even as adults. The schema usually does not go away without therapy. Overwhelming success in people’s lives is often not enough to change the schema. The schema fights for its own survival and, usually, is quite successful. Even though schemas persist once they are formed, they are not always in our awareness. Usually they operate in subtle ways, out of our awareness. However, when a schema erupts or is triggered by events, our thoughts and feelings are dominated by these schemas. It is at these moments that people tend to experience negative emotions and have dysfunctional thoughts. Schemas can also affect relationships in an adverse way.

Research has identified 18 specific schemas. Most clients have three or four schemas, and often more. The goals of this therapy are to help clients stop using maladaptive coping styles, heal their early schemas and eventually get their emotional needs met in everyday life and engage in more healthy relationships with others.

Clinical trials have shown schema therapy to be effective with clients that have long-standing and characterological difficulties (Giesen-Bloo et al. 2006).

References

Giesen-Bloo, J., Van Dyck, R., Spinhoven, P., Van Tilburg, W., Dirksen, C., Van Asselt, T., Kremers, I., Nadort, M., & Arntz, A. (2006). Outpatient Psychotherapy for Borderline Personality Disorder: a randomized trial of Schema focused therapy versus Transference focused therapy. Archives of General Psychiatry, 63, 649-658.

Young, J.E., Klosko, J.S., & Weishaar, M. (2003). Schema Therapy: A Practitioner's Guide. Guilford Publications: New York.

Young, J.E., and Klosko, (1993). Reinventing Your Life: How to Break Free from Negative Life Patterns. New York: Plume Books.