Schema Therapy (ST) is a flexible and comprehensive approach to therapy that focuses on understanding you as a person. It provides a helpful framework for us to make sense of some of the difficulties you might be experiencing. These might be difficulties with how you feel, your thought patterns, relationships, unhelpful behaviours, or a general dissatisfaction with your life.
ST was developed in the 1980s by psychologist Jeffrey Young and can be understood as an integrative model that draws on a number of therapeutic approaches, including cognitive behavioural (CBT), psychodynamic, gestalt, and person-centred.
CBT has a strong evidence base and because of this tends to be the treatment of choice for many common difficulties such as anxiety and depression; when delivering ST, I would be able to work with you to incorporate many of the effective components of CBT to support with the changes you make. In addition, ST goes deeper and puts more of an emphasis on understanding the links between childhood experiences and the development of patterns in thinking, feeling and behaving.
ST asserts that it is our schemas that link our past to our present. In ST, a schema can be understood as a deeply held belief which is often out of our conscious awareness. Schemas affect how we think, feel, and behave, and are sometimes described as our blueprints or software. They help us to make sense of the world, and are the patterns that run throughout our life. A goal of schema therapy is to help you to become more aware of your schemas and then to provide you with tools to change on an intellectual, emotional and behavioural level.
Another important part of ST is the focus on emotional needs. ST believes that schemas develop from experiences when our emotional needs were not met. One of the overarching goals of ST is to help you to develop an awareness of these needs and, over the course of therapy, develop a variety of ways of meeting them.
What happens in schema therapy?
In the early sessions of ST, we would work together to build an understanding of your current problems and how they developed. A crucial element of this is making links between your early life experiences and your current problems. The process of therapy is active, and, right from the start we would use different therapeutic techniques. These can be divided into: (i) emotion focussed strategies that aim to connect you with the emotional level of your experience, and include imagery and chair work; (ii) cognitive techniques that aim to promote flexible and compassionate thinking; and (iii) behavioural techniques that help you to challenge fears and break behavioural patterns.
What I like about schema therapy?
I really like the comprehensiveness and flexibility of ST. It provides a framework for understanding how we function on a deeper level and helps us to spot the common thinking and behavioural traps that we can all fall into. As a therapist I can be creative and draw on a number of proven techniques that aim to address problems on a variety of levels. ST also encourages therapists to play an active role in the therapy and to bring an authentic and open approach to the therapeutic relationship. This can help create a genuine connection, which is often the foundation for lasting change.
Dr John Burns is an experienced Consultant Clinical Psychologist registered with the British Psychological Society, Health and Care Professions Council, and the British Association of Behavioural and Cognitive Psychotherapies. He is available at our Brighton & Hove Practice.