Schema Therapy
Schema Therapy is a longer-term, integrative, evidence-based approach designed to help individuals understand and change deeply rooted emotional patterns that developed early in life. Drawing on elements of cognitive behavioural therapy (CBT), attachment theory, psychodynamic concepts, and experiential techniques, Schema Therapy is particularly effective for those struggling with complex trauma, especially trauma stemming from early childhood experiences such as neglect, abuse, or unmet emotional needs.
At the core of Schema Therapy is the concept of schemas—enduring and often unconscious beliefs about oneself, others, and the world, shaped by early life experiences. These schemas can create lifelong patterns of emotional distress, self-defeating behaviour, and difficulties in relationships. For individuals with complex trauma, these patterns often reflect attempts to cope with overwhelming emotions or unmet needs in childhood.
Schema Therapy helps clients identify and understand these patterns, known as maladaptive schemas or modes, and provides tools to change them. Through a combination of cognitive restructuring, emotional processing, and nurturing the healthy adult self, clients begin to heal from past wounds and develop more supportive ways of relating to themselves and others.
Treatment is typically delivered in individual therapy. Schema Therapy provides a compassionate, structured path for those living with the effects of complex trauma to reclaim a more stable, empowered, and emotionally connected life.
Want to book a session at Darlinghurst Psychologists?
Make an appointment here or contact our friendly team today at (02) 9331 3100
Schema Therapy – Frequently Asked Questions
Schema Therapy (ST) is designed to help individuals identify and heal early maladaptive schemas—enduring emotional and cognitive patterns that develop in childhood when core emotional needs are unmet. These schemas shape adult experiences, especially in relationships, self-worth, and emotional regulation. Schema Therapy integrates cognitive, experiential, and relational techniques to promote emotional healing and long-term change.
Reference: Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003)
Schema Therapy has strong evidence for:
- Personality disorders (especially Borderline, Avoidant, and Narcissistic)
- Complex PTSD and developmental trauma
- Chronic anxiety and depression
- Obsessive-compulsive personality traits
- Dysfunctional relationship patterns
Recent research also supports Schema Therapy in shorter formats (e.g., 8–20 sessions) for conditions like:
- Generalized anxiety disorder
- Social anxiety
- Panic disorder
- Depression (Major Depressive Disorder)
- Eating disorders
Reference : Malogiannis et al. (2014)
Schema Therapy focuses on two key constructs:
Early Maladaptive Schemas
These are deep-seated themes or patterns about oneself and others, formed during childhood or adolescence when emotional needs (e.g., for safety, validation, autonomy) are unmet. Examples include:
- Abandonment
- Mistrust/abuse
- Failure
- Emotional deprivation
- Unrelenting standards
Schemas tend to be rigid and self-perpetuating, influencing thoughts, behaviours, and relationships in adulthood.
See a full list on the Schema Therapy Institute website.
Schema Modes
Schema modes are moment-to-moment emotional states and coping styles that become activated in response to life events.
Edwards (2012) provides a widely used taxonomy of modes to guide assessment and intervention.
Sources: Young et al., 2003; Edwards, 2012
Schema Therapy can be delivered in:
- Individual therapy (weekly 50–60 minutes)
- Short-term or time-limited formats (e.g., 8–20 sessions for mood and anxiety disorders)
Common techniques include:
- Imagery rescripting – Rewriting early painful memories
- Chair dialogues – Engaging conflicting inner modes
- Cognitive restructuring – Challenging core beliefs
- Behavioural pattern-breaking – Practicing new responses
- Limited reparenting – Providing emotional correction within safe boundaries
While classic Schema Therapy for complex and chronic mental health concerns often spans 12–36 months, briefer protocols have shown efficacy for depression and anxiety when targeting specific schemas or modes.
Source: Bamelis et al., 2014; Malogiannis et al., 2014
Yes. Schema Therapy has been tested in both long-term and brief formats, with excellent results.
Schema Therapy is included in several national treatment guidelines (e.g., The Netherlands, UK NICE pathways) and is growing in international use.
Schema Therapy is ideal for people who:
- Struggle with long-term emotional or interpersonal patterns
- Have a history of complex trauma or neglect
- Desire a therapy that emphasizes emotional connection, healing, and depth
It can also be adapted to shorter durations for individuals with mood and anxiety disorders seeking deeper change beyond symptom relief.
Arntz, A., & Jacob, G. (2013). Schema therapy in practice: An introductory guide to the schema mode approach. Wiley-Blackwell.
Bamelis, L. L., Evers, S. M., Spinhoven, P., & Arntz, A. (2014). Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders. American Journal of Psychiatry, 171(3), 305–322. https://doi.org/10.1176/appi.ajp.2013.12040518
Edwards, D. J. A. (2012). A new taxonomy of schema modes: A guide to assessment and treatment. International Journal of Cognitive Therapy, 5(2), 135–161. https://doi.org/10.1521/ijct.2012.5.2.135
Giesen-Bloo, J., van Dyck, R., Spinhoven, P., van Tilburg, W., Dirksen, C., van Asselt, T., … & Arntz, A. (2006). Outpatient psychotherapy for borderline personality disorder: Randomized trial of schema-focused therapy vs transference-focused psychotherapy. Archives of General Psychiatry, 63(6), 649–658. https://doi.org/10.1001/archpsyc.63.6.649
Malogiannis, I. A., Arntz, A., Spyropoulou, A., Samakouri, M., Mavreas, V., & Young, J. E. (2014). Schema therapy for patients with chronic depression: A single case series study. Journal of Behavior Therapy and Experimental Psychiatry, 45(3), 319–329. https://doi.org/10.1016/j.jbtep.2014.03.006
van Vreeswijk, M., Broersen, J., & Nadort, M. (2014). The Wiley-Blackwell handbook of schema therapy: Theory, research and practice. Wiley-Blackwell.
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. Guilford Press.
Schema Therapy Institute. (n.d.). List of Early Maladaptive Schemas. Retrieved from https://www.schematherapy.com/id73.htm
