Schema therapy
Schema therapy, also known as schema-focused therapy, is a treatment specifically designed for individuals with chronic mental health disorders that some professionals consider difficult to treat. Schema therapy’s main objective is to assist individuals in identifying and changing early maladaptive schemas, which are pervasive and ingrained patterns of thought and behavior that originate in childhood and contribute to chronic mental health problems. It focuses on fulfilling core emotional needs and fostering healthier coping styles by addressing these schemas.
What are the origins of schema therapy?
Schema therapy was developed in New York by Dr. Jeffrey E. Young in the 1980s as an integrative approach combining cognitive therapies, psychodynamic concepts, and attachment theory. This approach was created to address chronic psychological issues by emphasizing emotional processing, experiential techniques, and the therapeutic relationship.
When is schema therapy used?
Schema therapy is commonly used for chronic depression, anxiety disorders, and personality disorders such as borderline personality disorder (BPD). It is also applied in cases of complex post-traumatic stress disorder, eating disorders, and relationship difficulties.
Schema therapy is primarily used in one-on-one settings to address core maladaptive schemas formed in early life, which influence patterns of thinking, feeling, and behaving in adulthood. Schema therapy groups have been found effective for BPD, eating disorders, and trauma survivors to receive validation and support from others. Schema therapists can also use this therapy in couples or family therapy where schemas interact negatively in relationship dynamics.
Schema therapy is used to treat a variety of issues, including personality disorders (especially borderline, narcissistic, and avoidant), childhood trauma and neglect, eating disorders, depression, complex PTSD, and minority stress in LGBTQ+ individuals. It addresses core emotional needs that were unmet in childhood and it is also useful in tackling longstanding self-worth issues and rigid beliefs.
What is schema therapy like?
Schema therapy is a long-term approach, often lasting six months to several years, depending on the complexity of the issues being addressed. Also, the number of sessions and frequency vary based on the severity of the presenting issues. For personality disorders, sessions take place weekly but may shift to bi-weekly depending on progress.
The first goal of schema therapy is psychological awareness. Therapists may ask questions about your early life experiences and core beliefs. These questions can include asking about what your relationships with your caregivers were like, if you felt safe and supported as a child, or if any significant early experiences shaped your worldview.
Schema therapy uses techniques such as imagery rescripting and chair work to help individuals reframe past experiences and change their emotional responses. The therapist may also temporarily address unmet emotional needs, which is known as limited reparenting. To further reinforce therapeutic progress, clients are often given homework assignments during their psychotherapy sessions, such as schema diaries, imagery exercises, or behavioral experiments.
How does schema therapy work?
Schema therapy can help people with long-standing depression by addressing the underlying maladaptive coping styles that contribute to their depressive symptoms such as social isolation or disconnection. Individuals with eating disorders like bulimia nervosa may struggle with allowing themselves to experience difficult thoughts or feelings. Schema therapy can be used to help them identify and restructure maladaptive schemas that contribute to their disordered eating behaviors, fostering healthier coping strategies and creating a resilient emotional state.
Severe anxiety disorders can also be treated with schema therapy.. Schema therapy works by helping individuals understand, avoid, and cope with the situations that trigger their urge to use, while also addressing the underlying maladaptive schemas that contribute to their behaviors and emotional state.
Schema therapy helps people break free from self-defeating negative patterns that started in childhood. When core emotional needs are unmet in childhood, an undeveloped self may emerge, leading to difficulties in identity formation and emotional regulation. Underlying schemas can be maladaptive, and shape how we see ourselves, others, and the world. This often leads to emotional distress and unhealthy behavior patterns that contribute to our fears or phobias.
In schema therapy, clinicians help clients identify these schemas and challenge the harmful beliefs attached to them by identifying coping modes. Coping modes can be categorized into vulnerable child modes and maladaptive parent modes. These schema modes have been developed to avoid emotional pain.
Through techniques inspired by Gestalt-like imagery rescripting (reframing painful memories), chair work (role-playing different parts of the self), and cognitive restructuring (changing negative thought patterns), clients learn to heal and develop healthier ways of thinking and behaving. A key part of the process is strengthening the healthy adult mode, allowing clients to manage emotions and relationships better, and healing the vulnerable child mode. Over time, schema therapy fosters increased positive well-being, emotional growth, and lasting change.
Is schema therapy effective?
Schema therapy is an effective treatment for various psychological conditions, with a strong record of success in treating personality disorders, chronic depression, and complex trauma. Schema therapy is effective in treating complex mental health conditions, particularly personality disorders, by addressing deep-seated emotional patterns and core needs. It helps modify early maladaptive schemas formed in childhood, which influence emotions and behavior patterns in adulthood.
How to find a therapist who practices schema therapy
If you think schema therapy might be right for you, it’s important to speak with a licensed and experienced clinician. There are many types of mental health care providers who practice schema therapy, including licensed marriage and family therapists (LMFTs), licensed clinical social workers (LCSWs), psychologists, psychiatrists, psychiatric nurses, licensed professional counselors (LPCs), licensed mental health counselors (LMHCs) and more.
On top of finding someone specializing in schema therapy, you want to make sure they meet your other needs. For example, if you’re struggling with symptoms of trauma, you may want to find a schema therapist who also specializes in trauma. In addition, finding a therapist who accepts your insurance can make therapy much more affordable.
You can find a therapist who accepts your insurance and specializes in schema by using Grow Therapy. After filtering for your location, insurance, and needs, you can then select “Schema Therapy” from the “Treatment methods” drop-down.