Schema Therapy

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/social-isolation

Subjugation

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/subjugation

Insufficient Self-Control

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/insufficient-self-control

Unhelpful Thinking Styles (Archived)

NOTE: Two improved versions of this resource are available here: Cognitive Distortions – Unhelpful Thinking Styles (Common) and Cognitive Disto . https://www.psychologytools.com/resource/unhelpful-thinking-styles-archived

Unmet Emotional Needs

Unmet emotional needs can give rise to early maladaptive schemas, and other forms of maladaptive coping. This Unmet Emotional Needs handout forms part . https://www.psychologytools.com/resource/unmet-emotional-needs

How Trauma Can Affect You (CYP)

Trauma can result in a wide variety of symptoms, experiences, and behaviors. As well as post-traumatic stress disorder (PTSD), prevalence rates of oth . https://www.psychologytools.com/resource/how-trauma-can-affect-you-cyp

Mistrust/Abuse

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/mistrust-abuse

What Are Schemas?

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and peoples’ characteristic responses to them, refer . https://www.psychologytools.com/resource/what-are-schemas

Abandonment

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/abandonment

Coping Styles And Responses (Schema Therapy)

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/coping-styles-and-responses-schema-therapy

Punitiveness

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/punitiveness

Pessimism

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/pessimism

Emotional Deprivation

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/emotional-deprivation

Failure To Achieve

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/failure-to-achieve

How Your Past Affects Your Present (Schema Therapy)

Schema therapy posits that many longstanding psychological difficulties stem from unmet core emotional needs, the early maladaptive schemas (EMS) they . https://www.psychologytools.com/resource/how-your-past-affects-your-present-schema-therapy

Core Belief Magnet Metaphor

Core beliefs (schemas) are self-sustaining. They act to 'attract' confirmatory evidence and 'repel' (or distort) disconfirmatory evidence. This inform . https://www.psychologytools.com/resource/core-belief-magnet-metaphor

Reciprocal CBT Formulation

CBT therapists often describe finding it difficult to apply CBT skills when clients bring relational problems to therapy. Familiar methods of visu . https://www.psychologytools.com/resource/reciprocal-cbt-formulation

Enmeshment

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/enmeshment

Defectiveness

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/defectiveness

Emotional Inhibition

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/emotional-inhibition

Schema Formulation

Beck's cognitive model proposes that cognition and perception in the here-and-now are influenced by our 'schemas', which shape our perception and info . https://www.psychologytools.com/resource/schema-formulation

Approval-/Admiration-Seeking

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/approval-admiration-seeking

Interpersonal Beliefs And Styles

Interpersonal issues and relationship problems form an important part of what clients bring to therapy: they might present as clients’ current conce . https://www.psychologytools.com/resource/interpersonal-beliefs-and-styles

Boundaries - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo . https://www.psychologytools.com/resource/boundaries-self-monitoring-record

Dependence / Incompetence

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/dependence-incompetence

Entitlement

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer . https://www.psychologytools.com/resource/entitlement

Schema Bias

Core beliefs (schemas) are self-sustaining. They act to 'attract' confirmatory evidence and 'repel' or 'distort' disconfirmatory evidence. This inform . https://www.psychologytools.com/resource/schema-bias

Schema Metaphors

Core beliefs (schemas) are self-sustaining. They act to 'attract' confirmatory evidence and 'repel' or 'distort' disconfirmatory evidence. This inform . https://www.psychologytools.com/resource/schema-metaphors

What Is Imagery Rescripting?

Unwanted images are a feature common to a variety of problems including PTSD and depression. Imagery rescripting is an evidence-based treatment techni . https://www.psychologytools.com/resource/what-is-imagery-rescripting

Links to external resources

Psychology Tools makes every effort to check external links and review their content. However, we are not responsible for the quality or content of external links and cannot guarantee that these links will work all of the time.

Assessment

• Young Schema Questionnaire – L2 (YSQ-L2) link Download

Information Handouts

• List of early maladaptive schemas | Schema Therapy Institute Of South Africa Download

Information (Professional)

• A client’s guide to schema-focused cognitive therapy | David Bricker, Jeffrey Young: Shcema Therapy Institute Download

Presentations

• Using schemas and schema modes as a basis for formulation and treatment planning in schema therapy | David Edwards Download

Websites

• Handouts & questionnaires for emotions, schema and personality | 2009 Download

Worksheets

• Log book for schema triggering and mode analysis Download

What Is Schema Therapy?

Assumptions of ST

• Everybody has emotional needs that are universal and present from childhood. These needs include: safety, stability, nurturance, acceptance, autonomy, competence, identity, expression, spontaneity, and for a world with realistic limits.
• Psychological health is the ability to get one’s needs met in an adaptive manner.
• During childhood people develop schemas—broad organizing principles—which help to guide them in making sense of their life and experiences. These are elaborated and developed over the lifespan. Schemas work as ‘shortcuts’—they help us to come quickly to what we think is likely to be true saving us from having to think /process every detail. They are not always accurate.
• Some schemas—particularly those acquired from toxic or traumatic childhood experiences where the young person’s needs were not met to a significant degree—are described as early maladaptive schemas and are responsible for difficulties relating to other people, personality disorders, and some mental health problems.
• Young, Klosko, and Weishaar (2003) defined early maladaptive schemas as:
  • a broad, pervasive theme or pattern;
  • composed of memories, emotions, cognitions, and bodily sensations;
  • regarding oneself and one’s relationships with others;
  • developed during childhood or adolescence;
  • elaborated throughout one’s lifetime; and
  • dysfunctional to a significant degree.
  • when the child’s early environment is missing something important such as love, stability, or understanding;
  • when the child is harmed or victimized (when the need for safety was unmet) and develops schemas which reflect danger, threat, or pain;
  • when the child is coddled/​indulged/​overprotected and did not receive sufficient freedom or autonomy;
  • when the child selectively identifies with the thoughts, feelings, experiences, and behaviors of an influential adult such as a parent.
  • schema surrender, which involves giving in to ones’ schemas;
  • schema avoidance, which means avoiding situations or people which trigger our schemas;
  • schema overcompensation which means doing the opposite of one’s schemas.
  • child modes (the vulnerable child mode is of the focus of therapy);
  • maladaptive coping modes;
  • dysfunctional internalized parent modes;
  • a healthy adult mode which is the part of the self that is capable, strong, and well-functioning.

  Types of Early Maladaptive Schemas

  Young and colleagues have identified 18 early maladaptive schemas, which can be assessed using the Young Schema Questionnaire (YSQ). They include:

  • abandonment/​instability
  • mistrust/​abuse
  • emotional deprivation
  • defectiveness/​shame
  • social isolation/​alienation
  • dependence/​incompetence
  • vulnerability to harm or illness
  • enmeshment / underdeveloped self
  • failure
  • entitlement/​grandiosity
  • insufficient self-control/​self-discipline
  • subjugation
  • self-sacrifice
  • approval-seeking/​recognition-seeking
  • negativity/​pessimism
  • emotional inhibition
  • unrelenting standards/​hypercriticalness
  • punitiveness

  Procedures and Techniques of ST

  • Schema therapy involves the task of limited reparenting in which the therapy relationship is one which recognizes, articulates, validates, and (to some extent) fulfils the needs of the patient.
  • The second ‘central pillar’ of schema therapy is empathic confrontation (Young et al., 2003) in which the therapist empathically, and nonjudgmentally confronts the patient on their maladaptive behaviors and cognitions, emphasizing their self-defeating nature.
  • Schema therapy case conceptualization is used to describe patient symptoms, identify current triggers, propose mechanisms for the emergence and maintenance of problems, and provides a ‘story’ about how the patients problems might be resolved.
  • Schema therapy makes extensive use of guided imagery as both an assessment tool, and as a technique for intervention.
  • Cognitive techniques used within schema therapy include: data collection, reframing/​reattribution, schema flashcards and diaries, and schema dialogues.
  • Emotion-focused techniques used with schema therapy include: role-play / chair work, and guided imagery.
  • Behavioral techniques used with schema therapy include: rehearsal of adaptive behavior in imagery or role-play, behavioral homework, and rewarding adaptive behavior.

  References

  • Jacob, G. A., & Arntz, A. (2013). Schema therapy for personality disorders—A review. International Journal of Cognitive Therapy, 6(2), 171–185.
  • Rafaeli, E., Bernstein, D. P., & Young, J. (2011). Schema therapy. CBT Distinctive Features Series. New York: Routledge.
  • Young, J. E., & Klosko, J. S. (1993). Reinventing your life: The breakthrough program to end negative behavior and feel great again. New York: Dutton.
  • Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. New York: Guilford Press.