Schema therapy is a form of cognitive therapy that was developed by psychologist Dr Jeffrey Young in the 1990s. Unlike cognitive behaviour therapy (CBT), schema therapy is a longer-term, more intensive treatment designed for people with longstanding, hard-to-treat problems such as recurrent patterns of depression, long-term OCD or other anxiety disorders, problems with intimate relationships and difficulties linked to painful experiences in childhood or adolescence.
Schema therapy is a warm, compassionate form of therapy that emphasises the relationship between therapist and client as an important part of the healing process. Clients are encouraged to stay in touch between sessions, especially if they are struggling, which can be very helpful when times are tough. In therapy we first identify which schemas a person has and how they developed in childhood (for example, someone may have an Abandonment schema, because one of their parents left the family or was emotionally unavailable for them).
We also identify your modes – distinct sides of you that become active at different times. For example, you may have a Punitive Parent mode, which is the part of you that criticises and attacks for you for perceived failings or mistakes. Clearly, this is both unhelpful and distressing, so we work together on pushing back against this mode, getting it to be quiet and give you some much-needed peace, calmness and compassion for yourself. And your Vulnerable Child mode is the part that feels vulnerable, lonely, anxious or threatened – this part needs nurturing, healing and protecting, which is a central part of the work in schema therapy.
CBT or schema therapy?
I would say that for most psychological problems, such as chronic stress, anger management, phobias, health anxiety, one-off episodes of depression, social anxiety, and so on, CBT is the most effective therapy for you. Having been a CBT therapist for many years, I am passionate about this practical, problem-solving, highly effective approach. It works really well for most problems, most of the time.
But I decided to train in schema therapy to help the people for whom CBT did not seem to be enough. Some of my clients just did not respond to CBT at all; others responded well for a while, then we seemed to hit a wall. Especially for problems related to childhood trauma, abuse or neglect, 'treatment-resistant' depression or anxiety disorders, or across-the-board problems affecting every area of someone's life, CBT techniques just did not work as well as I or my clients hoped.
Dr Young created schema therapy for people with exactly these kinds of problems. Because schema therapy involves working at a much deeper, more emotionally-focused level than with CBT, we can heal those past hurts that are causing you problems today. Using experiential techniques like imagery and chair work, we can help you release and process stuck or painful emotions, while shifting unhelpful ways of thinking and behaving that make day-to-day life a struggle.
Schema therapy is a highly effective, potentially transformative approach – and may well help even if you have tried CBT or other therapies before, with little success.
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