What is Schema Therapy?

In the early 1990ies it became increasingly clear that cognitive behavioral therapy  (CBT) offered a highly effective treatment for depression and anxiety disorders, but that the application in clients with personality disorders or disruptive character traits met with great difficulties. The multiple and rapidly changing problems and difficulties, the emotional instability and the regular lack of motivation in these patients combined with the difficulty to establish a stable and productive therapy relationship, posed great challenges for therapists. In order to try and overcome these difficulties, Jeffrey Young, a former student of Aaron Beck, compared the strengths and weaknesses of several therapy models such as Gestalt therapy, psychoanalysis, systemic therapy and attachment theory in order to identify effective elements and combine them with CBT techniques. This extensive developmental work resulted in a completely new integrative therapy model with a coherent theoretical basis and a well-structured set of practical techniques for change.

Key elements of schema therapy are: 

• The concept of core emotional needs (such as safety, attachment, self respect, autonomy)
• The relevance of childhood and adolescent experience for the development of repetitive life patterns and themes; so-called early maladaptive schemas
• The assumption that children try to overcome challenges and difficulties as good as they can by developing coping strategies (e.g. surrender, avoidance and overcompensation) which later in life can become increasingly rigid and dysfunctional.
• The application of experiential techniques for therapeutic change such as Imagery, role-play and chair work.
• A focus on the therapy relationship and the concept of limited reparenting within a therapeutic context.

Together with Dialectical Behavioral Therapy (DBT) and Acceptance and Commitment Therapy (ACT), Schema Therapy is one of the so-called ‘third-wave’ cognitive behavioral therapies. Schema Therapy has been shown to be an effective and successful treatment for several personality disorders (e.g. Borderline Personality disorder) and other mental health problems in numerous scientific studies.