Schema therapy
(ST)
Schema therapy (ST) is a form is psychotherapy that brings together elements from cognitive behavioural therapy (CBT), attachment and object relations theories, Gestalt and experiential therapies.
ST is aimed at addressing and resolving long standing problems, negative patterns of thinking and acting.
Schemas and early maladaptive schemas are themes and patterns at the core of people that create self-defeating thoughts, feelings, and behaviours.
A schema acts like a filter, through which a person views themselves, others and the world. Therefore all a persons thoughts, feelings and behaviours are effective by the schemas we have developed over our life. Unhelpful schemas can distort a person’s view and make it difficult to see the world, themselves and others in a fair or helpful way. These difficult schemas can result in unwanted affects on a personal mental health, their relationships and ability to live the life they want.
Schema therapy encourages a person to recognise and dispute these schemas to feel better and function well in society.
There are many different schema types, which will be assessed by a skilled therapist. A schema therapist will assess which schema types seem to be affecting the individual the most and work to lessen their impact.
How does a therapist use schema in treatment?
The goal of schema therapy is to help the client develop a more flexible and adaptive way of responding to life's challenges, and to foster a sense of self-acceptance and self-compassion.
In schema therapy, the therapist typically works with the client to identify and understand their maladaptive schemas and coping styles, and to develop and practice new, more adaptive ways of thinking and behaving.
During a schema therapy session, the therapist may use a variety of techniques to help the client identify and change their schemas and coping styles, including:
Schema mode work: The therapist helps the client identify which of their schema modes (e.g., the angry/impulsive mode, the compliant/self-sacrificing mode) are active in a given situation, and works with the client to develop more adaptive ways of responding.
Emotional awareness and expression: The therapist helps the client identify and label their emotions, and encourages the client to express and communicate their emotions in a healthy way.
Cognitive restructuring: The therapist works with the client to identify and challenge their maladaptive thoughts and beliefs, and to develop more realistic and adaptive ways of thinking.
Behavioral change: The therapist helps the client identify and practice new behaviors that are more in line with their goals and values.
Imagery and visualisation: The therapist may use imagery and visualisation techniques to help the client process and make sense of their experiences, and to develop new, more adaptive ways of responding to challenging situations.
What problems is schema therapy helpful for treating?
Schema therapy is a form of cognitive behavioural therapy that is designed to help people with longstanding, deeply ingrained patterns of thoughts, feelings, and behaviours that are causing them distress or interfering with their ability to lead a fulfilling and satisfying life. These patterns, known as "schemas," can be related to a wide range of problems, including:
Personality disorders: Schema therapy has been particularly effective in the treatment of personality disorders, such as borderline personality disorder, narcissistic personality disorder, and obsessive-compulsive personality disorder.
Mood disorders: Schema therapy can be helpful for people with depression and anxiety, as well as other mood disorders.
Relationship problems: Schema therapy can help people improve their relationships and communication skills, and to develop more satisfying and fulfilling relationships.
Trauma and abuse: Schema therapy can be an effective treatment for people who have experienced trauma or abuse, and who may have developed negative schemas as a result of these experiences.
Chronic pain and health problems: Schema therapy can be helpful for people with chronic pain or health problems, as it can help them develop more adaptive coping strategies and improve their overall quality of life.
Evidence base for the use of schema therapy
There is a growing body of research supporting the effectiveness of schema therapy. Studies have consistently shown that schema therapy is an effective treatment for a wide range of psychological problems, including personality disorders, mood disorders, and relationship problems.
One review of the research on schema therapy found that it was effective in reducing symptoms of personality disorders, improving interpersonal functioning, and increasing overall quality of life. Other research has shown that schema therapy is particularly effective for people with borderline personality disorder, and that it may be more effective than other forms of cognitive behavioural therapy for this population.
In addition, schema therapy has been found to be effective in the treatment of depression, anxiety, and other mood disorders. Studies have also shown that schema therapy can be an effective treatment for people with chronic pain and health problems, and can improve overall quality of life.
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