Schema Therapy

A therapist guides clients through schema therapy, which often starts with recognizing early patterns of thought and behavior that may negatively affect an individual. The method may also involve the following techniques or strategies: 

• Cognitive techniques: These methods help clients identify and challenge negative thoughts or beliefs related to schemas. For example, someone might learn to counter the thought "I'm unlovable" with evidence of being cared for and valued.
• Behavioral techniques: These strategies encourage individuals to test new behaviors in real-life situations. Someone with a "mistrust" schema might be guided to trust a friend with a small secret and observe the outcome.
• Emotion-focused techniques: These techniques involve processing emotions linked to schemas. For example, an individual can revisit past traumas⁴ in a safe environment to release pent-up emotions or practice techniques to regulate emotions in the present.
• A focus on childhood trauma: Often, maladaptive schemas are tied to adverse childhood events or patterns of neglect. Part of the therapy process might involve exploring these memories to understand and heal trauma, which may weaken the effects of the schema.

One or a combination of these techniques may be used for a client with a personality disorder or another mental health condition. However, schema therapy is often personalized to the needs of the individual and their coping styles. While schema therapy may alter harmful schemas and replace them with healthier beliefs, it may not be appropriate for all conditions. Therefore, consult a mental health professional for guidance. 

For those experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Schema therapy is conducted by a trained therapist over multiple sessions. Often, this therapeutic modality focuses on providing behavioral therapy to those with borderline personality disorder, early maladaptive schemas, and other mental health challenges. These sessions are often carried out regularly each week for at least six months. Schema therapy could last up to three years or more, depending on the condition being treated.

Initial sessions

During the initial session, a therapist may aim to understand your life history, significant events, schema modes, early maladaptive behaviors, and challenges. Understanding your story may help you identify potential schemas. Then, based on the initial discussion, you and your therapist can set therapeutic goals, which may guide the following sessions. In some cases, a therapist may use cognitive-behavioral therapy (CBT) alongside schema therapy to help individuals with maladaptive schemas and thoughts. 

Following sessions

With your therapist, you'll explore where schemas originated, whether from childhood experiences or certain life events. Your therapist can use active therapy techniques like those taught by the Society of Schema Therapy to help you dissect and alter your beliefs. Throughout schema therapy, you might learn new coping strategies and ways to manage your behavior. Over time, your therapist may review your progress and adjust based on any concerns.

One vital aspect of schema therapy is the therapeutic relationship. The therapist may perform various roles to help individuals heal from emotional wounds and challenge their schemas and limited reparenting beliefs. When seeking schema-focused therapy, it may be helpful to find a therapist with whom you feel comfortable and trust as you may be discussing potentially sensitive or difficult topics.

In addition, schema therapy can benefit from commitment. Each person’s experience is different, but with effort and a helpful therapist, it may lead to improved personal growth and positive changes. Look for a therapist with credentials in schema-based therapy, such as those with certification from the International Society of Schema Therapy. You might also consider an integrative therapist, who may offer cognitive-behavioral therapy and other modalities alongside schema-focused therapy for a more person-centered and holistic approach.

Schema therapy is a versatile approach to psychotherapy that may help people with various mental health conditions and challenges. People who might benefit from schema therapy include but are not limited to those affected by the following:

• Personality disorders: Individuals with conditions like borderline personality disorder (BPD) or narcissistic personality disorder (NPD) may develop an awareness of their behaviors through schema therapy. They might learn to identify and substitute unhealthy behaviors for healthier coping methods.
• Trauma and attachment challenges: Those who have faced complex trauma or childhood attachment challenges may benefit from schema therapy. With schema therapy, an individual may explore the roots of these problems, which could lead to improved understanding and healing.
• Chronic mental health concerns: For people living with ongoing conditions like depression or anxiety, schema therapy may pinpoint core beliefs that could be worsening symptoms. 
• Relationship difficulties: Whether the difficulties involve romantic ties or other relationships, schema therapy may provide insight into the beliefs and expectations causing interpersonal problems. Acknowledging these insights may help an individual develop healthier bonds with others.
• Eating disorders: Individuals with eating disorders like anorexia, bulimia, or binge eating disorder may discover that they have strong beliefs that are fueling their behaviors. By addressing these beliefs, the individual might learn to have a healthier relationship with self-image.
• Substance use challenges: Those struggling with addiction or living with a substance use disorder might find that underlying schemas are driving their compulsive behaviors or substance use. Schema therapy may offer tools to break these patterns and move toward recovery.

Schema therapy is a holistic approach that may resolve deep-seated beliefs and patterns accompanying various mental health challenges. Clients may achieve lasting change by targeting the root cause of symptoms.  

Schema therapy may seek to accomplish several goals, including but not limited to the following. 

Empowering the healthy adult mode

Schema therapy seeks to help individuals recognize their behavior patterns, especially those originating from their past. The main goal is to nurture and empower the “Healthy Adult" mode, which refers to the balanced and mature part of oneself. This mode is characterized by healthy coping skills and rational decision-making. It allows individuals to meet their needs and protect themselves from harm while considering the needs and feelings of others.

Healing from deep-seated beliefs

At the heart of schema therapy is the idea of early maladaptive schemas. Schema therapy aims to identify deeply ingrained beliefs and how they affect interactions with others as adults. By healing these early maladaptive schemas, individuals may develop an improved sense of self-worth and strengthen their relationships. As a result, they can ensure their emotional needs are met in their daily lives.

Reducing harmful coping methods

Schema therapy focuses on confronting maladaptive coping modes. These maladaptive coping strategies, which may include avoiding problems or overcompensating, may come from unhelpful beliefs. In this therapy, the goal is to lessen the influence of these coping modes, which can allow individuals to reconnect with their core needs, such as autonomy and stability.

Overcoming schema-driven life patterns and fulfilling core needs

Another goal of schema therapy is to regulate emotions and develop skills to overcome life's adversities. By breaking schema-driven life patterns, individuals may respond to situations from a place of understanding rather than reactiveness. Individuals may then fulfill their core emotional needs in everyday situations, which may lead to improved overall mental health.

Various studies have been conducted to evaluate the effectiveness of schema therapy for several mental health challenges. For example, recent research has shown that schema therapy can be effective in treating personality disorders.

The literature review, which included data from numerous trials and studies, found that schema therapy is more effective than other treatments for reducing symptoms of these personality disorders. In addition, group schema therapy was more effective than individual schema therapy.

Another recent review of different studies aimed to determine how effective schema therapy is for adults with eating disorders, which are often severe, chronic, and challenging to treat. After reviewing four articles that included 151 participants, the study found that schema therapy can effectively reduce symptoms and behaviors linked to eating disorders. The study found that schema therapy could be particularly beneficial for people with severe and long-lasting eating disorders.

Studies indicate schema therapy can effectively reduce early maladaptive schemas and improve symptoms of several mental health conditions. However, more research may be needed to further assess schema therapy's effectiveness and determine its potential uses.