Deciding to go into therapy can be hard enough, but deciding which type is best for you can present another obstacle, given the vast array of styles of therapy styles.

To demystify the process and give you insight into different kinds of therapy, in this post we’re going to look at schema focused therapy.

What is schema focused therapy?

Schema focused therapy aims to help clients understand and change problematic ways in which they might understand and interact with the world around them.

Pioneered in 1990, it is an integrative style of therapy, which means that it is based on the principles of several different established therapy styles. In this case, it combines the principles of cognitive behavioural therapy (CBT), experiential therapy and interpersonal therapy.

How does schema focused therapy work

To understand how schema focused therapy works, you need to look at how we learn about the world around us. This is known as schema theory.

What is a schema?

Jean Piaget, a renowned child psychologist, was the first to use the term schema. Put simply, a schema is the complete set of information we hold about something. When a child (or adult) learns something new about the world, that knowledge is placed into a specific schema.

How do schemas relate to mental health?

In general, these schemas are factually accurate, but sometimes we learn incorrect, unhelpful, or maladaptive relationships and responses to the things around us. This leads us to develop maladaptive schemas. These can then influence the way we respond to people and situations as adults.

Many of these maladaptive schemas are focused on how we relate to other people, how we express our emotional needs, and how we understand the emotional responses of others. Some symptoms of mental health issues can be understood as reasonable responses to an unhelpful understanding of the world.

How can schema focused therapy help?

Schema focused therapy aims to help clients to understand their existing schemas, including how and why they might have developed them, and to form new, adaptive schemas. These new schemas enable clients to approach their relationships and their emotions in a way that is healthy and sustainable.

The first step is to help clients to become aware of their schemas. Given that these schemas are very deeply-held beliefs, it can be difficult for you to even notice that they exist. For example, if you believe that “people will always let you down”, this could feel like an objective fact about the world, rather than a belief which may or may not be accurate.

Once clients recognise their maladaptive schemas, the therapist will then help them explore the idea that they might be able to change them. The client and therapist will then work together to try out alternative schemas, explore how these feel, and develop new ways of processing emotions and forming relationships.

Maladaptive schemas: A worked example

Schema focused therapy highlights 18 common maladaptive schemas that clients regularly struggle with. One of these is enmeshment. Enmeshment is when a client has an intense and unhealthy emotional attachment to others.

Enmeshment can develop if a child isn’t given the opportunity to learn about the boundaries that exist in healthy relationships. Children who are neglected may become so focused on their desire for close emotional relationships that they ignore the need for boundaries. Enmeshment can also follow on from excessively-controlled childhood experiences, where a child is taught that they are not permitted to have boundaries. When the child grows into an adult, they may struggle to form good quality relationships. They may find themselves in a series of abusive relationships, as the lack of boundaries matches their maladaptive schema.

If someone dealing with enmeshment starts schema focused therapy, they will work together with a therapist to understand where their enmeshment schema came from. They may discuss times when the client was punished for attempting to set boundaries. They will then work together to consider possible new schemas, such as “boundaries show respect and love, and help me build sustainable relationships”.

Schema focused therapy can be used to address a wide range of issues, including anxiety and depression, as well as those that have been resistant to other forms of psychotherapy. Evidence suggests that it is especially valuable for clients suffering from borderline personality disorder or other personality disorder.

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private psychiatric assessments and reviews to broader mental health care: join us today.