Schema Focused Therapy

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Schema therapy is a therapeutic approach that focuses on schemas—maladaptive thought patterns that can lead to unhealthy behaviours and difficulties in maintaining adult relationships. These schemas often form in childhood, particularly in children whose emotional and physical needs are unmet or those who are overindulged or lack appropriate boundaries. In adulthood, these schemas can negatively impact an individual’s thoughts and actions, resulting in avoidance, overcompensation, or excessive self-sacrifice, ultimately affecting relationships and emotional well-being.

The goal of schema therapy is to help individuals recognise their behaviours, understand the underlying causes, and change their thoughts and actions to cope with relationship challenges and emotions in healthier ways.

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Schema Focused Therapy

Break Free from Unhealthy Patterns with Schema Therapy

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Schema therapy is typically a longer-term process, lasting months rather than just a few sessions. Over time, therapists work with clients to identify their schemas, recognise their responses—termed "coping styles"—and learn healthier ways to fulfill their needs.

A strong therapeutic relationship is essential, allowing clients to feel comfortable and emotionally safe. Schema therapy emphasises empathic confrontation, where therapists respond to clients' schemas and behaviours with understanding, while also encouraging clients to recognise the need for change and providing them with tools to achieve it.

There are five primary groups of schemas:

Disconnection and Rejection

Beliefs that others cannot provide emotional support or that one is isolated from others.

Impaired Autonomy and Performance

Beliefs that one is destined for failure or cannot manage daily responsibilities independently.

Impaired Limits

Beliefs of superiority and entitlement to special treatment.

Other-Directedness

Beliefs that others' needs should always come before one's own, often leading to a loss of personal control.

Over Vigilance and Inhibition

Beliefs that expressing emotions will lead to negative outcomes or that negative experiences outweigh positive ones.

The 18 Schemas

There are 18 different schemas which represent specific emotional needs that were not adequately met in childhood or adolescence:

  1. Emotional Deprivation

    The belief and expectation that your primary needs will never be met. The sense that no one will nurture, care for, guide, protect or empathise with you.

  2. Abandonment

    The belief and expectation that others will leave, that others are unreliable, that relationships are fragile, that loss is inevitable, and that you will ultimately wind up alone.

  3. Mistrust/Abuse

    The belief that others are abusive, manipulative, selfish, or looking to hurt or use you. Others are not to be trusted.

  4. Defectiveness

    The belief that you are flawed, damaged or unlovable, and you will thereby be rejected.

  5. Social Isolation

    The pervasive sense of aloneness, coupled with a feeling of alienation.

  6. Vulnerability

    The sense that the world is a dangerous place, that disaster can happen at any time, and that you will be overwhelmed by the challenges that lie ahead.

  7. Dependence/Incompetence

    The belief that you are unable to effectively make your own decisions, that your judgment is questionable, and that you need to rely on others to help get you through day-to-day responsibilities.

  8. Enmeshment/Undeveloped Self

    The sense that you do not have an identity or “individuated self” that is separate from one or more significant others.

  9. Failure

    The expectation that you will fail, or belief that you cannot perform well enough.

  10. Subjugation

    The belief that you must submit to the control of others, or else punishment or rejection will be forthcoming.

  11. Self-Sacrifice

    The belief that you should voluntarily give up of your own needs for the sake of others, usually to a point which is excessive.

  12. Approval-Seeking/Recognition-Seeking

    The sense that approval, attention and recognition are far more important than genuine self-expression and being true to oneself.

  13. Emotional Inhibition

    The belief that you must control your self-expression, or others will reject or criticise you.

  14. Negativity/Pessimism

    The pervasive belief that the negative aspects of life outweigh the positive, along with negative expectations for the future.

  15. Unrelenting Standards

    The belief that you need to be the best, always striving for perfection or to avoid mistakes.

  16. Punitiveness

    The belief that people should be harshly punished for their mistakes or shortcomings.

  17. Entitlement/Grandiosity

    The sense that you are special or more important than others, and that you do not have to follow the rules like other people even though it may have a negative effect on others. Also, can manifest in an exaggerated focus on superiority for the purpose of having power or control.

  18. Insufficient Self-Control/Self-Discipline

    The sense that you cannot accomplish your goals, especially if the process contains boring, repetitive, or frustrating aspects. Also, that you cannot resist acting upon impulses that lead to detrimental results.

Common unhealthy coping styles include:

Surrender

Accepting the schema as fact, leading to self-destructive behaviours. For example, someone believing they deserve mistreatment may tolerate abuse.

Avoidance

Going to great lengths to prevent triggering the schema, which can include distracting behaviours like substance use or avoiding relationships.

Overcompensation

Reacting against the schema by behaving in ways contrary to it. While questioning a schema can be healthy, overcompensating may result in burnout or strained relationships.

Coping styles may evolve over time, even as the underlying schemas tend to remain stable, and individuals may display multiple coping styles in response to the same schema.

Once schemas and coping styles are identified, therapists use various techniques to alter the schemas and replace unhealthy coping strategies with adaptive behaviours. Cognitive techniques may involve challenging the validity of the schema, while behavioural methods could include role-playing situations that trigger the schema and practicing healthier responses.

Clients may be assigned homework between sessions, such as reviewing flashcards that challenge their schemas or keeping a “schema diary” to track experiences that trigger their schemas. In some cases, family members or close friends may be invited to join therapy sessions to help clients understand the impact of their schemas on relationships.

Schema-Focused Therapy (SFT) aims to help individuals identify and alter deeply ingrained patterns of thinking and behaviour—schemas—that often originate from early life experiences. By fostering self-awareness and emotional regulation, SFT promotes healthier relationships and personal growth, making it a valuable approach for addressing a wide range of psychological issues.

"Therapy is about giving our clients the tools to feel empowered and motivated to take charge of their progress, goals and general wellbeing."

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