In his book ‘Schema Therapy – a practitioners guide’ (2003) Jeffrey Young describes Schema therapy as ‘an innovative integrative therapy developed by Young and his colleagues that significantly expands on traditional cognitive-behavioural treatment concepts. The therapy blends elements from cognitive-behavioural, attachment, Gestalt, object-relations, constructivist and psychoanalytic school in a rich unifying conceptual and treatment model’.
Having trained in and applied these therapeutic approaches in clinical practice, I became aware, like Young and many other practitioners, that it provides relief for some clients in the short term, but that many clients fail to improve or relapse after treatment is withdrawn. The reason seemed to be that although the presenting problems are addressed, the underlying, chronic and entrenched patterns are not being dealt with.
Schema Therapy was developed to expand on cognitive-behavioural therapy by integrating techniques drawn from several schools of therapy. It places greater emphasis on exploring childhood and adolescent origins of psychological problems, on emotive techniques, on the patient – therapist relationship and on maladaptive coping-styles. Schema therapy has been proven successful in the treatment of chronic depression and anxiety, eating disorders, relationship problems and long term difficulties in maintaining satisfying intimate relationships.
Schemas are understood to be a pattern imposed on reality or experiences to help individuals explain it, to mediate perception and to guide their responses. Young believes that maladaptive schemas are primarily the result of toxic childhood experiences. They are usually self-defeating and repeat throughout life. Mal-adaptive behaviours are driven by mal-adaptive schemas.
The individual develop specific coping strategies to deal with difficult perceptions, which may be appropriate during childhood, but become dysfunctional in adulthood, so often ‘the solution becomes the problem’.
In Schema Therapy, the therapist supports the clients to uncover the basic developmental needs that were not met during childhood that underlie the dysfunctional schemas.