← All treatmentsPersonality and patterns

Schema therapy

Sometimes you react more strongly than the situation calls for. Or you walk into the same trap again and again. Schema therapy helps you understand where those patterns come from and how to break them.

What is schema therapy?

Schema therapy focuses on stubborn patterns of thought and behaviour that formed in childhood. We call these patterns schemas: deeply rooted beliefs about ourselves and the world, such as "I am not good enough" or "other people cannot be trusted".

Schemas are not irrational. They had a function at the time, they helped you cope with your situation as a child. But in adult life they stay active automatically, including in situations where they are no longer helpful. You then react more intensely than the situation calls for, or choose behaviour that protects you in the short term but causes damage in the long run.

Schema therapy combines CBT, Gestalt, attachment theory and other methods. It is a deep but also practical therapy: you work not only on insight, but also on learning new, healthier patterns.

Scientific basis: randomised controlled research shows that schema therapy is more effective than specialised TFP treatment for borderline personality disorder (Giesen-Bloo et al., 2006, Archives of General Psychiatry). In a group format it is also cost-effective for several personality disorders (Farrell et al., 2009). Young's 18 schemas have been clinically validated worldwide.

Schema modes: shifting states

Alongside schemas, modern schema therapy also works with schema modes. A mode is a shifting state of mood and behaviour that is triggered when a schema is activated. From one moment to the next you can slide into a vulnerable child mode (with feelings of helplessness or fear), or suddenly reason from a harsh inner critic that judges you or others severely.

Recognising these modes and understanding how they are triggered is a core part of the treatment. By learning to see your modes, you can handle them consciously instead of being steered by them automatically.

Who is it for?

✓Personality problems (for example borderline, avoidant, dependent)
✓Chronic depression or anxiety that does not respond enough to shorter therapy
✓Depression or anxiety without a personality disorder (shorter courses of 6 to 12 months)
✓Relationship problems that keep returning
✓A persistent negative self-image
✓People who get stuck despite earlier therapy

Related complaints

BorderlineDepressionAnxiety disorderAttachment issuesLow self-confidence

Related treatments

EMDRCBTACTPsychoeducation

Frequently asked questions

How long does schema therapy take?
With personality problems, schema therapy takes 1 to 3 years on average. For depression or anxiety without a personality disorder, shorter courses of 6 to 12 months are also common. The length depends on the severity of the complaints and the treatment goals.
Is schema therapy only for people with a personality disorder?
No. Schema therapy is used with anyone who notices that early patterns affect their current life, also without a formal personality diagnosis.
What is the difference with CBT?
CBT focuses primarily on current thoughts and behaviour. Schema therapy goes deeper: to the origin of those patterns in childhood and the emotional needs that were not met at the time.
What are schema modes?
Schema modes are shifting states of mood and behaviour that are triggered when a schema is activated. For example a sudden slide into a vulnerable child mode, or taking on a harsh inner critic. Recognising and working with these modes is a core part of modern schema therapy.

Ready for a first conversation?

Book an intake with a certified provider.

Book an intakeOther treatments

Sources: Young et al. (2003), Schema Therapy: A Practitioner's Guide · Giesen-Bloo et al. (2006), Archives of General Psychiatry · Farrell et al. (2009), Journal of Behavior Therapy