Schema Therapy (ST)

Schema therapy (ST) focuses on recognising and understanding one’s schemas; maladaptive patterns of thought which leads to unhealthy behaviour and relationships.

Adapting from earlier forms of therapy (such as Cognitive Behaviour Therapy (CBT), psychoanalysis, Gestalt therapy), therapists utilising ST will assist a client to recognise their unhealthy thoughts and its root cause. Then, the therapists will aim to change the client’s thought processes to encourage positive and healthy behaviour. Finally, clients will learn how to recognise negative thoughts and emotions, and find healthy ways to address them. 

Studies suggests that schemas often fall into one of the following 5 categories, and could affect a client in the follow ways:  

1. Disconnection & Rejection – leading clients to struggle in forming healthy relationships
2. Impaired Autonomy & Performance – making it difficult for clients to be independent functioning adults
3. Impaired limits – clients may find it challenging to form healthy boundaries or limit their impulses
4. Other Directedness – clients may prioritise the needs of others above their own (to an unreasonable degree)
5. Over Vigilance & Inhibition – clients may become overly sensitive to mistakes, and actively impose rules on themselves and others 

These schemas typically begin to develop during childhood when core emotional needs are not met. These core needs include (but are not limited to) the need for a sense of safety, the freedom of expression, and safe boundaries. Interestingly, these emotional needs are just as important to adults as it is to children. When the core emotional needs are not met as a child, children may grow up to develop negative thought processes (schemas), leading to unhealthy coping mechanisms. 

ST could help clients understand these emotional needs by addressing underlying schemas, and help them fulfil their emotional needs without relying on unhealthy coping mechanisms. During ST, the therapist will work with you to identify underlying schemas. The therapist will then discuss further into unhealthy coping behaviours, and rectify coping behaviours with you by practising healthy behaviours to satisfy your emotional needs. This could be done via emotion-focused techniques such as role-playing or chair work, or behaviour-focused techniques, such as rehearsal of adaptive behaviour or behavioural homework. 

Schema Therapy is particularly useful in treating personality disorders, such as borderline personality disorders. However, clients facing challenges relating to childhood trauma, eating disorder, and addictions, may find that Schema Therapy is helpful for them as well.