Why I Use Schema Therapy

Why I Use Schema Therapy
By: Dr. Nicholas Wakefield, D.Clin.Psy (UK), Clinical Psychologist

Schema Therapy is an integrative therapy, combining aspects of cognitive, behavioral, psychodynamic, attachment and Gestalt models.  It views the cognitive and behavioral aspects as vital to treatment, as in standard CBT, but gives equal weight to emotional change, experiential techniques, and the therapeutic relationship.  Like CBT, it is structured, systematic and specific.  As a psychologist and therapist, I am quite eclectic in my approach, believing that any one theory or model cannot fully explain the human condition.  Perhaps this is why I’m drawn to Schema Therapy and its integrative approach.

I’ve been practicing Schema Therapy for nearly 10 years with a varied client group, including offenders with psychosis and personality disorder, adults and teenagers with a range of emotional and interpersonal difficulties.  Apart from it being a structured, evidence-based therapeutic approach, what I like about Schema Therapy is that it is very client-centered.  The focus on early childhood experiences producing very problematic, and often shame-inducing, adult behavioral patterns allows the therapist and client to address such behaviors in a very sensitive but direct way.  The model sees these problems as childhood survival mechanisms that are no longer protecting, and often emotionally harming the adult.  In viewing them as survival mechanisms as a result of painful childhood experiences, it allows the client to feel less inadequate and shameful whilst still taking the responsibility to make changes in the here and now. It also encourages the client to see these problems as only a part of them and not the whole of their identity.

Another aspect of Schema Therapy that I find very effective, and enjoyable, is the experiential work. Through imagery and chair work, I am able to help give a client a voice and empower them to stand up to their schemas, and the experiences that led to their development. As a therapist, there is great satisfaction in enabling a client to take control of the unconscious drives that have been ruling their behavior.

I find Schema Therapy to be very useful with clients where they have had problems for a number of years, often receiving many different diagnoses at different times.  The Schema model allows for these different presentations and diagnoses to be part of the same underlying problem, just manifesting differently due to the varied survival mechanisms associated with the schemas.  A schema formulation helps the client and clinician to make sense of seemingly incompatible behaviors as part of avoidance or over-compensatory strategies.  This helps clients to make sense of their problems from a different perspective.

Schema-focused therapy is a powerful approach, which I believe helps and empowers clients to re-evaluate their difficulties and make positive changes in their life.

Published on Feb 11 2019