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Schema Therapy for chronic psychological problems and personality disorders

People with personality disorders or other chronic psychological problems have found traditional Cognitive Behavioural Therapy (CBT) has not always been effective in helping them overcome their difficulties. It was as a response to this that Jeffrey E. Young developed Schema Therapy. It is an integrative approach to therapy that builds upon CBT, but also draws upon elements from experiential, constructivist and psychodynamic approaches.

I use Schema Therapy in my work in addition to CBT as research has shown it to be a very effective way of working with entrenched psychological problems. In contrast to CBT, Schema Therapy places more emphasis on: exploring the childhood origins of current psychological difficulties; on techniques to help clients experience emotions in such a way as to heal them; the importance of the therapeutic relationship between therapist and client; and on unhelpful coping strategies.

The common types of issues that Schema Therapy has been shown to be effective with are: personality disorders (especially borderline personality disorder); chronic depression; chronic anxiety; eating disorders; repeated difficulties in maintaining intimate relationships; and relapse with substance abuse.

Schema Therapy proposes that chronic emotional difficulties arise when an individual’s core emotional needs are not met in childhood or adolescence. People then become stuck in self-defeating patterns that unwittingly get repeated again and again, thereby perpetuating their unmet needs. An example of this would be someone who had very demanding and critical parents, for whom nothing was ever good enough, who then goes through life expecting perfection of themselves and others, which then leads to problems, such as a lack of satisfying relationships or an inability to relax and enjoy life.

Treatment works by helping clients understand the patterns that they keep repeating, how these difficulties developed, and then exploring alternative strategies that will be more effective at helping them get their core emotional needs met.

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