Schema Therapy (or more properly, Schema-Focused Cognitive Therapy)is an integrative approach to treatment that combines the best aspects of cognitive-behavioral, experiential, interpersonal and psychoanalytic therapies into one unified model. Schema-Focused Therapy has shown remarkable results in helping people to change negative (“maladaptive”) patterns which they have lived with for a long time, even when other methods and efforts they have tried before have been largely unsuccessful.
The Schema-Focused model was developed by Dr. Jeff Young, who originally worked closely with Dr. Aaron Beck, the founder of Cognitive Therapy. While treating clients at the Center for Cognitive Therapy at the University of Pennsylvania, Dr. Young and his colleagues identified a segment of people who had difficulty in benefiting from the standard approach. He discovered that these people typically had long-standing patterns or themes in thinking, feeling and behaving/coping that required a different means of intervention. Dr. Young’s attention turned to ways of helping patients to address and modify these deeper patterns or themes, also known as “schemas” or “lifetraps.”
The schemas that are targeted in treatment are enduring and self-defeating patterns that typically begin early in life. These patterns consist of negative/dysfunctional thoughts and feelings, have been repeated and elaborated upon, and pose obstacles for accomplishing one’s goals and getting one’s needs met. Some examples of schema beliefs are: “I’m unlovable,” “I’m a failure,” “People don’t care about me,” “I’m not important,” “Something bad is going to happen,” “People will leave me,” “I will never get my needs met,” “I will never be good enough,” and so on.
Although schemas are usually developed early in life (during childhood or adolescence), they can also form later, in adulthood. These schemas are perpetuated behaviorally through the coping styles of schema maintenance, schema avoidance, and schema compensation. The Schema-Focused model of treatment is designed to help the person to break these negative patterns of thinking, feeling and behaving, which are often very tenacious, and to develop healthier alternatives to replace them.
Schema-Focused Therapy consists of three stages. First is the assessment phase, in which schemas are identified during the initial sessions. Questionnaires may be used as well to get a clear picture of the various patterns involved. Next comes the emotional awareness and experiential phase, wherein patients get in touch with these schemas and learn how to spot them when they are operating in their day-to-day life. Thirdly, the behavioral change stage becomes the focus, during which the client is actively involved in replacing negative, habitual thoughts and behaviors with new, healthy cognitive and behavioral options.