Developed by Dr. Jeffrey Young, schema therapy combines different aspects of cognitive behavioral therapy, gestalt therapy, psychoanalytic therapy and interpersonal therapy, among others. Schema therapy is commonly used to treat depression, trauma, personality disorders, anxiety, substance abuse and other mental health disorders. It can be effective individually as well as for couples.
The Goals of Schema Therapy
In at least a limited sense, schema therapy helps clients “reparent” themselves so they can get their emotional needs met in healthy ways. The primary goal of schema therapy is to change “schemas,” or entrenched or long-standing patterns of feeling, thinking and behaving and replace them with healthy patterns. These themes typically form early in life (though they can also form in adulthood) and have been repeated over and over even though they have prevented the person from functioning at their best. They usually center on specific themes, such as social isolation, helplessness, a sense of failure, fear of abandonment, avoidance of discomfort, mistrust of other people, shame, emotional deprivation and approval-seeking.
Examples of common schemas include:
- I’m not safe.
- I’m not worthy of love.
- I always get the short end of the stick.
- No one cares about me.
- I’ll never be good enough.
- I’ll never fit in.
- I should be able to have whatever I want.
- I am defective/bad/inadequate/inept.
- People always leave because something is wrong with me.
- Something always goes wrong.
Left unrecognized and unaddressed, schemas can lead to depression, relationship problems, codependency, angry outbursts, impaired social skills and passive-aggressive behavior. To cope with discomfort, shame and isolation, the person may abuse alcohol or other drugs.
The Stages of Schema Therapy
There are three primary stages of schema therapy. These include:
- Assessment – The client works with their therapist to identify problematic patterns
- Emotional Awareness – The client learns more about their schemas and how to identify them as they go about their daily lives.
- Behavioral Change – The client actively works to replace negative, self-defeating ways of thinking and behaving with healthier alternatives.
This approach is particularly effective with treatment-resistant clients who have had limited success with other approaches. Schema therapy helps clients build self-worth, improve their relationships and work toward achievable goals. Some of the therapeutic techniques employed in schema therapy include journaling, imagery, flash cards and chair work (creating dialogues between personalities in two chairs to work through interpersonal issues and identify core messages).