Table of ContentsView All
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Table of Contents
What Are Schemas?
Childhood Needs and Maladaptive Schemas
What Is the Goal of Schema-Focused Therapy?
What Conditions Can Schema-Focused Therapy Help Treat?
Techniques
Benefits
Limitations
Effectiveness
How to Find a Qualified Therapist
Frequently Asked Questions
Schema-focused therapy is a type of psychotherapy that involves changing unhealthy and self-defeating behavior patterns using a combination of cognitive, behavioral, and emotion-focused techniques. In addition, there is a focus on the patient-therapist relationship, daily life outside of therapy, and the impact of childhood traumas.
This article explains what schemas are and why they are unhelpful, the goals of schema-focused therapy, as well as schema therapy techniques, benefits, limitations, and effectiveness.
Schemas are thought patterns that inform a person’s worldview. Schemas could include negative ideas like “I’ll never find love” or “I’m a damaged person.”
Schemas can manifest in the following ways:
Schema therapy addresses unmet childhood needs that create negative schemas. These schemas include:
A cluster of schemas and negative coping styles is known as a mode, these include the following:
There are several goals of schema-focused therapy, including:
Schema-focused therapy has been applied to several mental disorders, including:
After determining your core schemas, a therapist might use the following techniques:
There are many potential benefits to schema-focused therapy, including:
There are some limitations to schema-focused therapy, including:
Who Might Not Benefit From Schema-Focused TherapySchema therapy might not help those who:Are unable to commit to long-term therapyMight not be able to manage the intense emotions that emerge during the change process, which is a phase that begins after a feeling of comfort is established with a therapistAre seeking to heal the neurological (brain functioning) effects of mental health disorders
Who Might Not Benefit From Schema-Focused Therapy
Schema therapy might not help those who:Are unable to commit to long-term therapyMight not be able to manage the intense emotions that emerge during the change process, which is a phase that begins after a feeling of comfort is established with a therapistAre seeking to heal the neurological (brain functioning) effects of mental health disorders
Schema therapy might not help those who:
Schema therapy might be more effective than “treatment as usual” for personality disorders. For example:
The following are other disorders for which schema-focused therapy has shown promise:
Schema therapy has also been studied for individuals convicted of crimes and hospitalized. One study showed it might reduce the likelihood of relapse and increase the chance of reintegrating into society.
Before finding a schema-focused therapy specialist, you’ll want first to confirmwhat kind of mental health treatment is available, depending on your insurance coverage status.
If you have insurance, you may want to:
If you don’t have insurance you may consider:
Also ask about availability outside of sessions, since being available over email could help with your schema-based therapy.
Summary
Schema-focused therapy combines several psychotherapy techniques to focus on changing maladaptive schemas, which are rigid patterns of thinking, feeling, and behaving. It uses cognitive, behavioral, and experiential based intervention as well as the power of the therapeutic relationship to facilitate change. The therapy was first found effective for borderline personality disorder, but it has been used to treat other personality disorders, anxiety and mood disorders, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and eating disorders.
A Word From Verywell
Finding the right kind of therapy is not an easy process, especially for those with unmet childhood needs and difficulty connecting. Schema-focused therapy is a great way to address many concerns while also having clear labels for confusing issues that can interfere with daily life. The method requires a long-term commitment, but it could provide just the support you need to work toward a more fulfilling life.
Cognitive behavioral therapy focuses on the present-day and changing thoughts that drive feelings and behaviors.Schema therapy, on the other hand, uses a combination of CBT, psychoanalytic, attachment, and Gestalt therapy models in addressing childhood wounds. It uses the patient-therapist relationship to try and provide some unmet childhood needs. Schema-focused therapy can require a long-term commitment of at least a year, while CBT emphasizes efficiency and can be short-term.Learn MoreWhat Is Cognitive Behavioral Therapy?
Cognitive behavioral therapy focuses on the present-day and changing thoughts that drive feelings and behaviors.Schema therapy, on the other hand, uses a combination of CBT, psychoanalytic, attachment, and Gestalt therapy models in addressing childhood wounds. It uses the patient-therapist relationship to try and provide some unmet childhood needs. Schema-focused therapy can require a long-term commitment of at least a year, while CBT emphasizes efficiency and can be short-term.
Learn MoreWhat Is Cognitive Behavioral Therapy?
Learn MoreWhat is an Anxiety Disorder?
Schema domains are five categores of unmet needs. They are each associated with maladaptive schemas. They are:Disconnection and rejection: These include schemas like expecting abandonment, feeling flawed, and being socially isolated.Impaired autonomy and performance: A sense of failure and being overly dependent are in this category.Other-directedness: This domain is about giving control to others and includes the schema of self-sacrifice.Overvigilence and inhibition: This domain includes schemas that guard against being vulnerable or imperfect, such as emotional inhibition and perfectionism.Impaired limits: This domain includes schemas like entitlement and lack of self-control.Learn MoreChild Development Theories and Examples
Schema domains are five categores of unmet needs. They are each associated with maladaptive schemas. They are:Disconnection and rejection: These include schemas like expecting abandonment, feeling flawed, and being socially isolated.Impaired autonomy and performance: A sense of failure and being overly dependent are in this category.Other-directedness: This domain is about giving control to others and includes the schema of self-sacrifice.Overvigilence and inhibition: This domain includes schemas that guard against being vulnerable or imperfect, such as emotional inhibition and perfectionism.Impaired limits: This domain includes schemas like entitlement and lack of self-control.
Schema domains are five categores of unmet needs. They are each associated with maladaptive schemas. They are:
Learn MoreChild Development Theories and Examples
27 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Division 12 of the American Psychological Association.Schema therapy for borderline personality disorder.American Psychological Association.Schema.Schema Therapy Institute.About schema therapy.Gülüm İV.Dropout in schema therapy for personality disorders.Res Psychother. 2018;21(2):314. doi:10.4081/ripppo.2018.314Tan YM, Lee CW, Averbeck LE, et al.Schema therapy for borderline personality disorder: a qualitative study of patients’ perceptions.PLoS ONE. 2018;13(11):e0206039. doi:10.1371/journal.pone.0206039The British Psychological Society.Schema therapy: working with complex clinical presentations and personality-based problems.American Psychology Association.Narcissistic personality disorder.American Psychological Association.Paranoid personality disorder.American Psychological Association.Histrionic personality disorder.Dadomo H, Grecucci A, Giardini I, Ugolini E, Carmelita A, Panzeri M.Schema therapy for emotional dysregulation: theoretical implication and clinical applications.Front Psychol. 2016;7. doi:10.3389/fpsyg.2016.01987Webb CA, Beard C, Forgeard M, Björgvinsson T.Facets of mindfulness predict depressive and anxiety symptom improvement above cbt skills.Mindfulness.2019;10(3):559-570. doi:10.1007/s12671-018-1005-1NHS.How it works - Cognitive behavioural therapy (CBT).Schneider Bakos D, Eduardo Gallo A, Wainer R.Systematic review of the clinical effectiveness of schema therapy.Contemp Behav Health Care. 2015;1(1):11-15. doi:10.15761/CBHC.1000104de Klerk N, Abma TA, Bamelis LLM, Arntz A.Schema therapy for personality disorders: a qualitative study of patients’ and therapists’ perspectives.Behav Cogn Psychother. 2017;45(1):31-45. doi:10.1017/S1352465816000357International Society of Schema Therapy.No change in neuropsychological function or emotional processing during treatment of major depression with cognitive-behaviour therapy or schema therapy.Bamelis LLM, Evers SMAA, Spinhoven P, Arntz A.Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders.AJP.2014;171(3):305-322. doi:10.1176/appi.ajp.2013.12040518Porter RJ, Bourke C, Carter JD, et al.No change in neuropsychological dysfunction or emotional processing during treatment of major depression with cognitive-behaviour therapy or schema therapy.Psychol Med. 2016;46(2):393-404. doi:10.1017/s0033291715001907Hawke LD, Provencher MD.Schema theory and schema therapy in mood and anxiety disorders: a review.J Cogn Psychother. 2011;25(4):257-276. doi:10.1891/0889-8391.25.4.257Knapík P, Slancová K.Core beliefs - schemas and coping styles in addictions.CRJ. 2020;9(3):9-19. doi:10.5507/crj.2020.003Peeters N, van Passel B, Krans J.The effectiveness of schema therapy for patients with anxiety disorders, OCD, or PTSD: a systematic review and research agenda.Br J Clin Psychol. 2021. doi:10.1111/bjc.12324Loyola University New Orleans.How to find a therapist.American Psychological Association.How do I find a good therapist?Kaczkurkin AN, Foa EB.Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence.Dialogues in Clinical Neuroscience. 2015;17(3):337-346. doi:10.31887/DCNS.2015.17.3/akaczkurkinAmerican Psychological Association.What is cognitive behavioral therapy?Morvaridi M, Mashhadi A, Shamloo ZS, Leahy RL.The effectiveness of group emotional schema therapy on emotional regulation and social anxiety symptoms.J Cogn Ther. 2019;12(1):16-24. doi:10.1007/s41811-018-0037-6Khaleghi M, Leahy RL, Akbari E, Mohammadkhani S, Hasani J, Tayyebi A.Emotional schema therapy for generalized anxiety disorder: a single-subject design.International Journal of Cognitive Therapy. 2017;10(4):269-282. doi:10.1521/ijct.2017.10.4.269Schema Therapy Society.The schema therapy model.
27 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Division 12 of the American Psychological Association.Schema therapy for borderline personality disorder.American Psychological Association.Schema.Schema Therapy Institute.About schema therapy.Gülüm İV.Dropout in schema therapy for personality disorders.Res Psychother. 2018;21(2):314. doi:10.4081/ripppo.2018.314Tan YM, Lee CW, Averbeck LE, et al.Schema therapy for borderline personality disorder: a qualitative study of patients’ perceptions.PLoS ONE. 2018;13(11):e0206039. doi:10.1371/journal.pone.0206039The British Psychological Society.Schema therapy: working with complex clinical presentations and personality-based problems.American Psychology Association.Narcissistic personality disorder.American Psychological Association.Paranoid personality disorder.American Psychological Association.Histrionic personality disorder.Dadomo H, Grecucci A, Giardini I, Ugolini E, Carmelita A, Panzeri M.Schema therapy for emotional dysregulation: theoretical implication and clinical applications.Front Psychol. 2016;7. doi:10.3389/fpsyg.2016.01987Webb CA, Beard C, Forgeard M, Björgvinsson T.Facets of mindfulness predict depressive and anxiety symptom improvement above cbt skills.Mindfulness.2019;10(3):559-570. doi:10.1007/s12671-018-1005-1NHS.How it works - Cognitive behavioural therapy (CBT).Schneider Bakos D, Eduardo Gallo A, Wainer R.Systematic review of the clinical effectiveness of schema therapy.Contemp Behav Health Care. 2015;1(1):11-15. doi:10.15761/CBHC.1000104de Klerk N, Abma TA, Bamelis LLM, Arntz A.Schema therapy for personality disorders: a qualitative study of patients’ and therapists’ perspectives.Behav Cogn Psychother. 2017;45(1):31-45. doi:10.1017/S1352465816000357International Society of Schema Therapy.No change in neuropsychological function or emotional processing during treatment of major depression with cognitive-behaviour therapy or schema therapy.Bamelis LLM, Evers SMAA, Spinhoven P, Arntz A.Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders.AJP.2014;171(3):305-322. doi:10.1176/appi.ajp.2013.12040518Porter RJ, Bourke C, Carter JD, et al.No change in neuropsychological dysfunction or emotional processing during treatment of major depression with cognitive-behaviour therapy or schema therapy.Psychol Med. 2016;46(2):393-404. doi:10.1017/s0033291715001907Hawke LD, Provencher MD.Schema theory and schema therapy in mood and anxiety disorders: a review.J Cogn Psychother. 2011;25(4):257-276. doi:10.1891/0889-8391.25.4.257Knapík P, Slancová K.Core beliefs - schemas and coping styles in addictions.CRJ. 2020;9(3):9-19. doi:10.5507/crj.2020.003Peeters N, van Passel B, Krans J.The effectiveness of schema therapy for patients with anxiety disorders, OCD, or PTSD: a systematic review and research agenda.Br J Clin Psychol. 2021. doi:10.1111/bjc.12324Loyola University New Orleans.How to find a therapist.American Psychological Association.How do I find a good therapist?Kaczkurkin AN, Foa EB.Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence.Dialogues in Clinical Neuroscience. 2015;17(3):337-346. doi:10.31887/DCNS.2015.17.3/akaczkurkinAmerican Psychological Association.What is cognitive behavioral therapy?Morvaridi M, Mashhadi A, Shamloo ZS, Leahy RL.The effectiveness of group emotional schema therapy on emotional regulation and social anxiety symptoms.J Cogn Ther. 2019;12(1):16-24. doi:10.1007/s41811-018-0037-6Khaleghi M, Leahy RL, Akbari E, Mohammadkhani S, Hasani J, Tayyebi A.Emotional schema therapy for generalized anxiety disorder: a single-subject design.International Journal of Cognitive Therapy. 2017;10(4):269-282. doi:10.1521/ijct.2017.10.4.269Schema Therapy Society.The schema therapy model.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Division 12 of the American Psychological Association.Schema therapy for borderline personality disorder.American Psychological Association.Schema.Schema Therapy Institute.About schema therapy.Gülüm İV.Dropout in schema therapy for personality disorders.Res Psychother. 2018;21(2):314. doi:10.4081/ripppo.2018.314Tan YM, Lee CW, Averbeck LE, et al.Schema therapy for borderline personality disorder: a qualitative study of patients’ perceptions.PLoS ONE. 2018;13(11):e0206039. doi:10.1371/journal.pone.0206039The British Psychological Society.Schema therapy: working with complex clinical presentations and personality-based problems.American Psychology Association.Narcissistic personality disorder.American Psychological Association.Paranoid personality disorder.American Psychological Association.Histrionic personality disorder.Dadomo H, Grecucci A, Giardini I, Ugolini E, Carmelita A, Panzeri M.Schema therapy for emotional dysregulation: theoretical implication and clinical applications.Front Psychol. 2016;7. doi:10.3389/fpsyg.2016.01987Webb CA, Beard C, Forgeard M, Björgvinsson T.Facets of mindfulness predict depressive and anxiety symptom improvement above cbt skills.Mindfulness.2019;10(3):559-570. doi:10.1007/s12671-018-1005-1NHS.How it works - Cognitive behavioural therapy (CBT).Schneider Bakos D, Eduardo Gallo A, Wainer R.Systematic review of the clinical effectiveness of schema therapy.Contemp Behav Health Care. 2015;1(1):11-15. doi:10.15761/CBHC.1000104de Klerk N, Abma TA, Bamelis LLM, Arntz A.Schema therapy for personality disorders: a qualitative study of patients’ and therapists’ perspectives.Behav Cogn Psychother. 2017;45(1):31-45. doi:10.1017/S1352465816000357International Society of Schema Therapy.No change in neuropsychological function or emotional processing during treatment of major depression with cognitive-behaviour therapy or schema therapy.Bamelis LLM, Evers SMAA, Spinhoven P, Arntz A.Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders.AJP.2014;171(3):305-322. doi:10.1176/appi.ajp.2013.12040518Porter RJ, Bourke C, Carter JD, et al.No change in neuropsychological dysfunction or emotional processing during treatment of major depression with cognitive-behaviour therapy or schema therapy.Psychol Med. 2016;46(2):393-404. doi:10.1017/s0033291715001907Hawke LD, Provencher MD.Schema theory and schema therapy in mood and anxiety disorders: a review.J Cogn Psychother. 2011;25(4):257-276. doi:10.1891/0889-8391.25.4.257Knapík P, Slancová K.Core beliefs - schemas and coping styles in addictions.CRJ. 2020;9(3):9-19. doi:10.5507/crj.2020.003Peeters N, van Passel B, Krans J.The effectiveness of schema therapy for patients with anxiety disorders, OCD, or PTSD: a systematic review and research agenda.Br J Clin Psychol. 2021. doi:10.1111/bjc.12324Loyola University New Orleans.How to find a therapist.American Psychological Association.How do I find a good therapist?Kaczkurkin AN, Foa EB.Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence.Dialogues in Clinical Neuroscience. 2015;17(3):337-346. doi:10.31887/DCNS.2015.17.3/akaczkurkinAmerican Psychological Association.What is cognitive behavioral therapy?Morvaridi M, Mashhadi A, Shamloo ZS, Leahy RL.The effectiveness of group emotional schema therapy on emotional regulation and social anxiety symptoms.J Cogn Ther. 2019;12(1):16-24. doi:10.1007/s41811-018-0037-6Khaleghi M, Leahy RL, Akbari E, Mohammadkhani S, Hasani J, Tayyebi A.Emotional schema therapy for generalized anxiety disorder: a single-subject design.International Journal of Cognitive Therapy. 2017;10(4):269-282. doi:10.1521/ijct.2017.10.4.269Schema Therapy Society.The schema therapy model.
Division 12 of the American Psychological Association.Schema therapy for borderline personality disorder.
American Psychological Association.Schema.
Schema Therapy Institute.About schema therapy.
Gülüm İV.Dropout in schema therapy for personality disorders.Res Psychother. 2018;21(2):314. doi:10.4081/ripppo.2018.314
Tan YM, Lee CW, Averbeck LE, et al.Schema therapy for borderline personality disorder: a qualitative study of patients’ perceptions.PLoS ONE. 2018;13(11):e0206039. doi:10.1371/journal.pone.0206039
The British Psychological Society.Schema therapy: working with complex clinical presentations and personality-based problems.
American Psychology Association.Narcissistic personality disorder.
American Psychological Association.Paranoid personality disorder.
American Psychological Association.Histrionic personality disorder.
Dadomo H, Grecucci A, Giardini I, Ugolini E, Carmelita A, Panzeri M.Schema therapy for emotional dysregulation: theoretical implication and clinical applications.Front Psychol. 2016;7. doi:10.3389/fpsyg.2016.01987
Webb CA, Beard C, Forgeard M, Björgvinsson T.Facets of mindfulness predict depressive and anxiety symptom improvement above cbt skills.Mindfulness.2019;10(3):559-570. doi:10.1007/s12671-018-1005-1
NHS.How it works - Cognitive behavioural therapy (CBT).
Schneider Bakos D, Eduardo Gallo A, Wainer R.Systematic review of the clinical effectiveness of schema therapy.Contemp Behav Health Care. 2015;1(1):11-15. doi:10.15761/CBHC.1000104
de Klerk N, Abma TA, Bamelis LLM, Arntz A.Schema therapy for personality disorders: a qualitative study of patients’ and therapists’ perspectives.Behav Cogn Psychother. 2017;45(1):31-45. doi:10.1017/S1352465816000357
International Society of Schema Therapy.No change in neuropsychological function or emotional processing during treatment of major depression with cognitive-behaviour therapy or schema therapy.
Bamelis LLM, Evers SMAA, Spinhoven P, Arntz A.Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders.AJP.2014;171(3):305-322. doi:10.1176/appi.ajp.2013.12040518
Porter RJ, Bourke C, Carter JD, et al.No change in neuropsychological dysfunction or emotional processing during treatment of major depression with cognitive-behaviour therapy or schema therapy.Psychol Med. 2016;46(2):393-404. doi:10.1017/s0033291715001907
Hawke LD, Provencher MD.Schema theory and schema therapy in mood and anxiety disorders: a review.J Cogn Psychother. 2011;25(4):257-276. doi:10.1891/0889-8391.25.4.257
Knapík P, Slancová K.Core beliefs - schemas and coping styles in addictions.CRJ. 2020;9(3):9-19. doi:10.5507/crj.2020.003
Peeters N, van Passel B, Krans J.The effectiveness of schema therapy for patients with anxiety disorders, OCD, or PTSD: a systematic review and research agenda.Br J Clin Psychol. 2021. doi:10.1111/bjc.12324
Loyola University New Orleans.How to find a therapist.
American Psychological Association.How do I find a good therapist?
Kaczkurkin AN, Foa EB.Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence.Dialogues in Clinical Neuroscience. 2015;17(3):337-346. doi:10.31887/DCNS.2015.17.3/akaczkurkin
American Psychological Association.What is cognitive behavioral therapy?
Morvaridi M, Mashhadi A, Shamloo ZS, Leahy RL.The effectiveness of group emotional schema therapy on emotional regulation and social anxiety symptoms.J Cogn Ther. 2019;12(1):16-24. doi:10.1007/s41811-018-0037-6
Khaleghi M, Leahy RL, Akbari E, Mohammadkhani S, Hasani J, Tayyebi A.Emotional schema therapy for generalized anxiety disorder: a single-subject design.International Journal of Cognitive Therapy. 2017;10(4):269-282. doi:10.1521/ijct.2017.10.4.269
Schema Therapy Society.The schema therapy model.
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