Schema therapy

Written by Katherine Nicholls
Katherine Nicholls
Counselling Directory Content Team

Last updated 4th January 2023 | Next update due 3rd January 2026

Dr Jeff Young developed the schema-focused approach in an attempt to help those who had not been successful using the cognitive behavioural approach (CBT). Schema therapy combines elements of cognitive, behavioural, attachment, psychodynamic and gestalt models, making it truly integrative.

In a similar way to CBT, this therapy is structured and specific, however the time it takes and the focus of sessions will vary according to the individual. Here, we’ll look at this in more detail and explain what schemas are, how this approach can help and what to expect if you undergo schema therapy.


What is schema therapy?

Schema therapy (also referred to as schema-focused cognitive therapy) aims to change negative patterns or beliefs that people have lived with for a long time. These longstanding patterns or themes are called ‘schemas’ within schema therapy.

These schemas typically begin early in our life, often when emotional needs are unmet. Though, sometimes, they can form later on in adulthood. Here are just a few examples of schemas that can be helped with schema therapy:

  • Abandonment - The belief that others will leave you, that people are unreliable and that relationships are fragile.
  • Underdeveloped self - Having the sense that you do not have an identity or are an individual.
  • Vulnerability - Feeling as if the world is a dangerous place and that disaster can strike at any time.
  • Negativity/pessimism - A constant belief that negative aspects in life outweigh the positives and having a pessimistic outlook for the future.

Such schemas can be reinforced by certain behaviours, patterns of thinking and the mind’s coping strategies, known as 'coping styles'. Coping styles are an individual's way of avoiding the painful emotions associated with a schema. Whilst they can be helpful in childhood, if left untreated, they can become problematic in later life. The goal of schema therapy is to help you break these ways of thinking, feeling and behaving, and replace them with healthier alternatives.

Schemas are considered to be more deeply held than ‘core beliefs’ which are often worked on in CBT. They are thought to have a greater influence on how our identity is formed and are more resistant to change.

Because of this, schema therapy may be recommended to you if you have not had success with cognitive approaches.

In this video, Clinical Psychologist Dr. Aisha Tariq discusses schema therapy in more detail. 

What can it help with?

Initially, schema therapy was developed to treat borderline (or emotionally unstable) personality disorder (BPD/EUPD) however it is now used to help many conditions and concerns.

In general, this therapy can help those who feel the origin of their condition/concern comes from their early life. It can also help those who seem to experience recurring negative life patterns and those who have struggled to make progress using other approaches.

What to expect

Schema therapy is considered a long-term intervention, which means the therapy lasts as long as you need it to. There tend to be three stages; assessment, change and behavioural pattern-breaking. These will last varying amounts of time depending on the individual.  


During this initial phase, your counsellor will be getting to know you and understanding what your particular schemas look like, when they originated and how they affect you. There are several techniques used to help this process, including imagery work and questionnaires.


In the change phase, role-playing and imagery work will often be employed, helping to overcome your schemas. Further on in this stage, the focus shifts to reinforcing healthy change.

Pattern-breaking (and preparing for the end of therapy)

Towards the end of your therapy, the emphasis will be on behavioural changes and pattern-breaking. You’ll then prepare for the end of therapy. This preparation will vary depending on your counsellor and how they like to work, but the aim will always be for you to feel comfortable and confident in your abilities.

Finding a professional

If you're ready to connect with a schema therapist, you can use our advanced search to find a qualified professional in your area or online. Take the time to browse the profiles listed to ensure you find a therapist that best resonates with you. Building a trusting relationship is an important step to getting the most out of your sessions. 

Search for a counsellor
Trusted Information Creator - Patient Information Forum

Trust our content

We are a PIF TICK 'trusted information creator'. This means you can be assured that what you are reading is evidence-based, understandable, jargon-free, up-to-date and produced to the best possible standard.

All content was accurate when published.


Find a therapist dealing with Schema Therapy

All therapists are verified professionals

All therapists are verified professionals