Schema Therapy

What is Schema Therapy?

Schema therapy is a medium- to longer-term talking therapy. Some people have 20 – 25 sessions, whereas others have Schema Therapy for a year or longer.

Schema Therapy is underpinned by several principles: 1) as children, we all develop ways of making sense of ourselves, others and the world – these frameworks are called schemas, and they include beliefs, emotions and physical feelings; 2) when a person has recurrent challenging, traumatic or distressing experiences during childhood, they can develop schemas that are negatively or self-critically skewed – such as thinking that they are a weak person or inferior in some way, or that others cannot be trusted; 3) these types of schemas are understandable in the context of difficult life experiences that were not the person’s fault; 4) people develop coping styles and strategies called modes, based on their schemas (and their life experiences), and to meet unmet needs; 5) sometimes these ways of coping are less helpful, and inadvertently, reinforce negative schemas; and 6) Schema Therapy helps people to process upsetting and traumatic life events and childhood memories, and develop extra ways of managing difficult emotions and unmet needs, including having more useful and less risky ways of coping.

Good Schema Therapy does not involve invalidating a person’s thoughts or emotions, or blaming them for sometimes using less helpful coping strategies.

Good Schema Therapy should incorporate key stages, including learning more about the theory behind Schema Therapy (sometimes called psychoeducation), identifying life events, relationships and memories that have may contributed to negative schemas and less helpful ways of coping (often called ‘life traps’) arising and persisting, processing difficult experiences from childhood and testing out different ways of coping of responding to and relating to past, present and anticipated challenges. 

Schema Therapy focuses both on the ‘here and now’ and the past. So, some sessions focus on talking about how past events or experiences link to negative schemas, difficult emotions and current distress. However, there is also an emphasis on developing additional coping strategies that are helpful day-to-day, especially in the context of forming and maintaining friendships and relationships.

Aside from seeing a therapist privately, Schema Therapy may be available via NHS Psychological Therapies services, that are situated across England - your GP should be able to advise about referral routes.

If you would like more information about Schema Therapy, the ISST website (International Society of Schema Therapy; the body that oversees training and accreditation for therapists) may be a helpful resource.

Does Schema Therapy work?

There has been some research into the effectiveness of Schema Therapy, although there is general consensus that more studies are needed.

Overall, the evidence suggests that Schema Therapy can improve mental health and emotional wellbeing, and day-to-day functioning in people who have difficulties with forming and maintaining friendships and relationships. Some studies show that self-harming and risky behaviours reduce after Schema Therapy.

How can Schema Therapy help me?

Schema therapy can help you to:

• beliefs (schemas) and thinking styles may impact on and be impacted by emotions

• understand how life events have contributed to the development of less helpful coping patterns

• identify different ways of thinking about, and coping, with challenging or upsetting situations

• become more confident in social interactions, friendships and relationships

• be less self-critical

• feel more able to be kind to yourself

• have better self-esteem

• problem-solve more effectively