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. The longstanding patterns or themes are called ‘schemas’ within schema therapy.
These schemas typically begin early in our life, 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 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. The goal of schema therapy is to help you break these ways of thinking, feeling and behaving, and replacing 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 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.
What can it help with?
Initially, schema therapy was developed to treat borderline personality disorder (BPD) 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 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.