Schema Therapy: A Practitioner's Guide

The schema approach draws equally from cognitive-behavioral therapy, attachment theory, psychodynamic concepts, and emotion-focused therapies. In comparison to cognitive-behavioral therapy, schema therapy emphasizes lifelong patterns, affective change techniques, and the therapeutic relationship, with special emphasis on limited reparenting. Schema therapy is particularly well-suited for difficult, resistant clients with entrenched, chronic psychological disorders, including personality disorders (including borderline personality disorder and narcissism) and eating disorders, intractable couples problems, and criminal offenders. It has also been found to be effective for relapse prevention in depression, anxiety, and substance abuse. The initial results of a major comparative outcome study have shown schema therapy to be effective with a high percentage of outpatients with borderline personality disorder, with a low dropout rate. Clients who have spent years gaining valuable insight with psychodynamic treatments, but who are frustrated by their lack of progress, often respond well to the active, systematic, flexible, and depth-oriented schema approach.