Schemas are the ideas and beliefs that help us make sense of ourselves and our environment. Negative schemas can result from adverse childhood experiences, often with primary caregiver(s).
Schema therapy helps people identify unhelpful patterns that stem from the past. It’s designed to challenge deep self-beliefs, so it may take longer than other forms of care.
Schema therapy has been used to treat personality disorders, anxiety, depression, and more. It can help improve your self-esteem, self-regulation, and relationships.
Schema therapy [1] was originally created as a treatment for personality disorders and treatment-resistant conditions like persistent depression. Today, it’s used to help treat a variety of other conditions [2]. It builds on concepts from cognitive behavioral therapy [3] (CBT) to help people overcome unhelpful beliefs.
Schema theory states that if we don’t have our basic needs met as children, we may develop negative beliefs about ourselves in adulthood [2]. These negative beliefs can affect how we feel about ourselves and the world around us. Schema therapy works by helping people uncover, address, and replace these beliefs with more functional ones.
Understanding different types of schemas
The challenges that lead to the development of negative schemas can vary from person to person. But experts have identified a few consistent themes within this experience.
The five main categories of schemas [4] are:
Disconnection and rejection: This schema often develops due to an insecure attachment. When a child experiences rejection or neglect from their caregiver, they grow up to expect that people will abandon them. This can lead to rocky or unstable adult relationships.
Impaired autonomy and performance: This schema can result from overprotective parenting. When a child doesn’t get to practice solving problems and exploring the world, they may come to see themselves as incapable. They may have a hard time developing a sense of agency or independence as adults.
Impaired limits: This schema can arise due to overly permissive parenting or if caregivers don’t set healthy boundaries. Without experience adhering to limits, a person may go on to have trouble with self-regulation or impulse control.
Other directedness: This schema can develop if a person grows up believing that love is conditional. They may come to believe that they have to perform a certain way to “earn” their caregivers’ love. Later in life, they may experience people-pleasing tendencies or frequently put others’ needs before their own.
Overvigilance and inhibition: This schema can occur in people who grew up with overly strict or authoritative parents. The dynamic can cause them to develop a rigid sense of morality that prevents them from expressing themselves authentically.
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How schema-focused therapy works
Schema therapy is founded on the belief that schemas are adaptable. While you can’t change your childhood experiences, you can evolve how you see yourself and relate to others.
The main goals of schema therapy [5] are to:
Help people meet their emotional needs in healthy ways
Reduce avoidance and unhealthy coping strategies
Improve self-regulation and reduce reactivity
Overcome self-criticism and negative self-talk
Much like in CBT, schema therapy views the therapist–client relationship as an important part of healing and personal growth. During sessions, therapists use an intervention called “limited reparenting” [6] to:
Explore, with their client, which schema(s) they resonate most with, often with the use of questionnaires [7]
Provide clients with healthy, corrective emotional experiences (within professional boundaries)
Validate their client’s feelings and create a safe environment for them to open up
Help their client understand where their schema framework came from
There’s no set number of sessions for schema therapy. Treatment duration depends on the person’s needs and preferences. However, because schema therapy is designed to dismantle core beliefs, it can take longer [8] than other forms of care.
For example, the goal of CBT is to identify and replace unhelpful thoughts to inspire behavior change. CBT assumes that this shift can occur relatively quickly with the right support. But because schema therapy is intended to explore deeper themes, it often lasts longer.
What is schema therapy used for
Schema therapy was first created to treat personality disorders [3] and help people who haven’t found relief from other forms of care. While research on schema therapy is limited, there’s evidence to suggest that it can help people living with:
Substance use disorders [9] (SUDs)
Anxiety disorders [2]
Obsessive-compulsive disorder [2] (OCD)
Post-traumatic stress disorder [2] (PTSD)
Eating disorders [10] (EDs)
Depression [10]
Taking the first steps toward schema therapy
To get started with schema therapy, search online directories and teletherapy platforms for providers who practice it. You can also ask a current provider (your doctor, psychiatrist, etc.) for a referral.
Feel free to ask prospective therapists if they use schemas in their approach if you aren’t sure. Even if it’s not a main area of focus, it might be something they can incorporate into your sessions.
Once you start schema therapy, remember that it may take some time to see progress. Schema shifts can be subtle. But you’ll know that it’s working when you begin to see yourself as separate from your past experiences, have more self-esteem, and feel more confident in your relationships.
Schema therapy can be especially helpful for people who haven’t found relief with shorter-term treatments because it goes deeper. Instead of only focusing on thoughts or behaviors, it helps uncover long-standing emotional patterns that started in childhood and continue to shape how a person feels, reacts, and connects with others.
Brandy Chalmers, LPC
Clinical reviewer
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Schema therapy is designed to help people counteract negative beliefs that stem from childhood. It was first created for treatment-resistant symptoms and personality disorders. But it's now used to help people with anxiety disorders, depression, OCD, PTSD, and more. Over time, it can help people overcome unhelpful beliefs, improve their self-esteem, and form healthier adult relationships.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
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References
- schema therapy https://dictionary.apa.org/schema-therapy
- The effectiveness of schema therapy for patients with anxiety disorders, OCD, or PTSD: A systematic review and research agenda https://pmc.ncbi.nlm.nih.gov/articles/PMC9544733/#bjc12324-sec-0028
- Does schema therapy change schemas and symptoms? A systematic review across mental health disorders https://pmc.ncbi.nlm.nih.gov/articles/PMC5573974/
- Exploring the associations between early maladaptive schemas and impulsive and compulsive buying tendencies https://pmc.ncbi.nlm.nih.gov/articles/PMC10362270/
- The Schema Therapy Model https://schematherapysociety.org/Schema-Therapy
- Limited reparenting as a corrective emotional experience in schema therapy: A preliminary task analysis https://pubmed.ncbi.nlm.nih.gov/33910484/
- Quick Self Test Schemas Ruining Life https://www.schemainstitute.co.uk/quick-self-test-schemas-ruining-life/
- Summary of Results of a Major Outcome Study: Schema Therapy for Borderline Personality Disorder https://www.schematherapy.com/id316.htm
- Dual Focus Schema Therapy for personality disorders and substance dependence: Case study results https://www.sciencedirect.com/science/article/pii/S1077722900800838
- The higher-order structure of early maladaptive schemas: A meta-analytical approach https://pmc.ncbi.nlm.nih.gov/articles/PMC9753131/#s4
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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