Dr.

Jeffrey Young

- American psychologist best
known for having developed
the schema therapy. He is the
founder of Schema Therapy
Institute.

- I look for negative life
patterns and help clients to
change them.
Described are
innovative ways to
rapidly conceptualize
challenging cases,
explore the client's
childhood history,
personality disorders.
book can help
people change their
lives by stopping the
cycle of self-
destruction.
"Do you put the needs
of others before your
own?
- Challenges facing cognitive behavioral therapy
today is developing effective treatments for these
chronic, difficult to treat patients.

- Characterological problems can reduce the
effectiveness of traditional cognitive behavioural
therapy.

- Young who originally worked closely with Dr. Aaron
Beck, the founder of Cognitive Therapy.developed
schema therapy to treat patients with chronic
characterological problems. Treatment failures

Mario presents for CBT treatment for agoraphobia.
Programs consist of breathing training and
challenging catastrophic thoughts. He significantly
reduces his fear of panic symptoms. Treatment
ends, patient lapses back into her agoraphobia. He
had been in the lifetime of dependence with CBT.


- The feeling of incompetence which what we call
DEPENDENCE AND VULNERABILITY SCHEMAS has been
adapted.

Schema Therapy is designed for characterological
problems and not acute psychiatric symptoms.

Schema Therapy expanded form of CBT that put
much emphasis on exploring the childhood , and
maladaptive coping styles.

Schema focused
model of
treatment is
designed to
help the person
to break these
negative
patterns of
thingking,
feeling and
behaving.


Theories on which Schema Therapy is based

Schema Domain Early Maladaptive Schemas

Coping Styles/Responses

Schema Modes

1. Schema Domain Category of the
met Emotional unwanted of the child

2. Early Maladaptive Schema-
Repeatedly use throughout our lives.




Domain 1
(Disconnection/rejection)
1. Abandonment
2. Mistrust
3. Emotional
Deprivation
4. Shame
5. Social isolation
Domain 2
(Impaired Performance)

1. Dependence
2. Vulnerability to
harm/illness
3. Undeveloped Self
4. Failure


Domain 3
(Impaired Limits)

1. Entitlement
2. Insufficient Self Control

Domain 4
(Other Directedness)

1. Subjugation
2. Self Sacrifice
3. Approval Seeking


Domain 5
(Over Vigilance and Inhibition)

1. Negativity/Pessimism
2. Emotional Inhibition
3. Hyper criticalness
4. Punitiveness


A young woman named kyla comes for treatment.
Kyla was an only child with emotionally cold
parents. Although they met all of her physical needs,
they did not nurture her or give her sufficient
attention or affection. They did not try to understand
who she was. In her family, Kyla felt alone. She tells
her therapist that she has been depressed her whole
life.


Kyla has generally been attracted from handsome
men. Her husband, ramon, fits this pattern. When
Ramon goes to kyla for holding or sympathy, she
becomes irritated and pushes him away. The result is
, she becomes angry. She felt suffocated by normal
expression of tenderness.


3. Coping Style/Responses- The way we
adapt to schemas


maladaptive behaviors develop as a
responses to a schema, Thus behaviors are
driven by schemas but are not part of the
schemas (Young 1990,1999)

BEHAVIOR IS NOT PART OF THE SCHEMA, IT IS
PART OF THE COPING PROCESS!!
Coping style





Coping Response
Three maladaptive coping Style

Surrender Accepting that schema is true
Avoidance- Avoidance of situations that
may triggers the schema
Overcompensation- Too much of being
positive

Joseph usually avoid almost any situation in
which his schema of abandonment is
triggered. When his gf threatened to breakup
with him he always get drunk until he passed
out.

What is the coping style ? What is the Coping
response?

Avoidance is the coping style for abandonment
and drinking beer is the coping response



4. Schema modes lie for a
long time and being
activated by triggers.

Emotional states that lie dormant for a long time and
being activated by certain triggers.

Child Modes

1. vulnerable child
2. Angry Child
3. Undisciplined Child
4. happy Child

Emotional states that lie dormant for a long time and
being activated by certain triggers.

Maladaptive Coping Styles

1. Compliant Surrenderer
2. Detached Protector
3. Over Compensator



Emotional states that lie dormant for a long time and
being activated by certain triggers.

Maladaptive Parent Modes

1. Punitive Parent
2. Demanding Parent



Emotional states that lie dormant for a long time and
being activated by certain triggers.


Healthy Adult Mode

1. Healthy Adult


Schemas begin in early childhood or
adolescence as reality-based representations of
the childs environment. Early Maladaptive
Schemas and the maladaptive ways in which
patients learn to cope with them often underlie
chronic Axis I symptoms, such as anxiety,
depression, substance abuse, and
psychosomatic disorders. Schemas are
dimensional, meaning they have different levels
of severity and pervasiveness. The more severe
the schema, the greater the number of situations
that activate it.

Early Life Experiences
Toxic childhood experiences are the primary
origin of Early Maladaptive Schemas. There are
four types of early life experiences that foster the
acquisition of schemas.

The first is toxic frustration of needs. Occurs when
the child experiences too little of a good thing
and acquires schemas such as Emotional
Deprivation or Abandonment through deficits in
the early environment.




The second type of early life experience that
engenders schemas is traumatization or
victimization. The child is harmed or victimized
and develops schemas such as Mistrust/ Abuse,
Defectiveness/Shame, or Vulnerability to Harm.



Third type, the child experiences too much of a
good thing: The parents provide the child with
too much of something that, in moderation, is
healthy for a child. With schemas such as
Dependence/Incompetence or Entitlement/
Grandiosity, for example, the child is rarely
mistreated. Fourth type of life experience that
creates schemas is selective internalization or
identification with significant others



Emotional Temperament
Emotional temperament interacts with painful
childhood events in
the formation of schemas. Different
temperaments selectively expose children to
different life circumstances.

The goal of Schema Therapy is to help patients get
their core emotional needs met.
Identifying early maladaptive schemas that are
maintaining the presenting problem behaviours and
seeing how these schemas are played out in
everyday situations.
Changing dysfunctional beliefs and building
alternative beliefs, this can be used to fight the
schemas.
Breaking down maladaptive life patterns into
manageable steps and changing the coping styles,
which maintain the schemas, one step at a time.

The goal of Schema Therapy is to help patients get
their core emotional needs met.
Providing patients with the skills and experiences that
will create adaptive thinking and healthy emotions.

Empowering patients and validating their emotional
needs that were not met, so that their needs will be
met in everyday life.

To support parents in the recognition and reduction
of dysfunctional, maladaptive, emotional caused by
their own schemas.
Explore and identify the origins of schemas
The goal of Schema Therapy is to help patients get
their core emotional needs met.
Link current problems and symptoms to schemas
and modes

Utilize cognitive strategies to build a rational
response to each maladaptive schema and mode

Use behavioural techniques to change patterns that
perpetuate maladaptive schemas and modes

Apply experiential techniques (such as imagery, for
example) to change emotional learning

The goal of Schema Therapy is to help patients get
their core emotional needs met.
Use the therapy relationship as a safe place to
identify and heal schemas and modes

Encourage and guide maintaining and developing
healthy relationships

Build the health adult to maximize ability to get
core needs met


Therapist in training is flexible enough to
allow for different interpersonal styles but
encourages the person to be particularly
attentive to their ability tore-parent
effectively.
Good schema therapist should be
personally affected by their therapy with
clients, and emphasis is placed on the
need genuinely to care about them.

Flexible
The ability to be comfotable being
openly warm and caring, and able to
share these feelings with the patient in
order to create a re-parenting bond is
vital.
Therapist have a clear understanding of
their own emotional needs through the
formulation of early experiences and
schema development.

The treatment process presents the steps in
assessing and changing the schemas.
Assessment Phase
Assessment comes with, life history interview,
self monitoring and schema questionnaires.
Education Phase
Identify schemas and understand the origins
of the schemas in childhood and
adolescence.
Change Phase
The goal is to convince patients that their
schemas are false






1. Cognitive Techniques
2. Experiential techniques
3. Behavioral Pattern Breaking





Patients learn to disprove the validity of their
schema.

MY SCHEMA IS FALSE!!!

(Emotional Awareness)


Patient talks about what they needed but did
not receive from the parents when they were
children.

Sets of childhood pictures comes with this
process.

Therapist encourages patients to make
healthier choices.

Patient will discuss the result from imagery,
role playing to therapist and Therapist will try
to evaluate how patient acknowledge the
learning from it.
Integrative systematic model of
treatment for a wide spectrum of
chronic, difficult and psychological
problems.

Schema Therapy is broader, both
conceptually and in terms of techniques

Schema therapy provides a
straightforward, direct approach that
goes beyond getting "in-touch" with your
feelings.

Schema Therapy is similar in going
deeper, and Schema Therapy focuses
on feelings and thoughts that are out of
the peoples awareness.

Cant make your problems go away
without your co-operation.

Consumes lot of your time.

It may not be suitable for people
with more complex mental health needs
or learning difficulties.

You may feel more anxious or
emotionally uncomfortable.

It will not address the possible underlying
causes of mental health conditions, such
as an unhappy childhood.

It will not address wider problems in
systems or families that often have a
significant impact on an individuals
health and wellbeing.

Not offered with psychiatric symptoms


Schema Therapy
for Borderline
Personality
Disorder

Schema Therapy
for Bipolar
Personality
Disorder

Schema Therapy for
Personality
Disorders

Schema Therapy with
Chronic depression
Beckley, K. A. (in press). Team Dynamics: A
schema-focused approach. In P. Willmot &
N.S.

Hartung, M., Terwilliger, J., & Rahm, E. (2011).
Schema Matching and Mapping. (Z.
Bellahsene, A. Bonifati, & E. Rahm,
Eds.)Evolution (Vol. 141, pp. 149190). Springer
Berlin Heidelberg.

TEMPLE, S. D. (2003). Schema Therapy: A
Practitioners Guide. American Journal of
Psychiatry.

Wegener, I., Alfter, S., Geiser, F., Liedtke, R., &
Conrad, R. (2013). Schema change without
schema therapy: the role of early
maladaptive schemata for a successful
treatment of major depression. Psychiatry,
76(1), 117.

Young, J.E., Arntz, A., Atkinson, T., Lobbestael,
J., Weishaar, M., van Vreeswijk, M and
Klokman, J. (2008). Schema Mode Inventory.
Schema Therapy Institute, 130 West 42nd St.,
Ste. 501, New York, NY 10036.

YoungChapt1.pdf. (n.d.). Retrieved
September 03, 2014, from
http://www.therapist-
training.com.au/SCHEMA/YoungChapt1.pdf

Bernstein, B. D., & Nentjes, L. (n.d.). Schema
Therapy for Forensic Patients with Personality
Disorders Manual 2: Theoretical Manual .




Kellogg, S. H., & Young, J. E. (2006). Schema
Therapy for Borderline Personality Disorder ,
62(4), 445458. doi:10.1002/jclk

http://www.therapist-
training.com.au/SCHEMA/YoungChapt1.pdf