Week 9-11 - Schema

Question 1

What are the characteristics of clients with chronic difficulties?

Answer 1

• Rigidity
• Avoidance
• Interpersonal difficulties
• Emotional dysregulation

Question 2

What are the chronological steps in Beck’s Cognitive Model that apply to Schema

Answer 2

• Childhood experience.
• Formation of core beliefs.
• Conditional follow on assumptions/rules/beliefs
(e.g., If X then Y).
• Compensatory strategies.

Question 3

What is part of Beck’s Cycle & Schema

Answer 3

• Activating event
• Automatic Negative Thought
• Meaning of the Thought – linked to schemas.
• Emotion
• Behaviour

Question 4

What does Young define as an Early Maladaptive Schema, and what are other names for them?

Answer 4

Early Maladaptive Schema (EMS) = stable and
enduring themes which develop during childhood
and will operate throughout an individual’s life.
• EMS, also called Core Beliefs, Lifetraps, Scripts, or
Silent assumptions.

Question 5

What are some EMS defining Characteristics

Answer 5

• Unconditional beliefs about oneself – implicit & rarely
questioned.
• Self-perpetuating and resistant to change.
• By definition are maladaptive.
• Activated by events related to the schema.
• High levels of affect when activated.
• Origins typically in childhood experiences.

Question 6

What are the 4 things kids need to develop (and to avoid developing maladaptive schemas)

Answer 6

1: Connectedness
2: Worthiness
3: Autonomy
4: Fair expectations and
realistic limits

Question 7

What are the 5 Schema Domains

Answer 7

• DISCONNECTION & REJECTION
• IMPAIRED AUTONOMY & PERFORMANCE
• IMPAIRED LIMITS
• OTHER DIRECTEDNESS
• OVERVIGILANCE & INHIBITION

Question 8

What are the 18 Schemas?

Answer 8

• Abandonment/Instability – instability/unreliability of
support/connection.
• Mistrust/Abuse – others will hurt me.
• Emotional Deprivation – deprivation of nurturance,
empathy, protection.
• Defectiveness/Shame – feeling defective, bad, unwanted,
inferior.
• Social Isolation/Alienation – isolated/different.
• Dependence/Incompetence – unable to handle
everyday responsibilities.
• Vulnerability to Harm/Illness – medical, emotional,
natural.
• Enmeshment/Undeveloped Self – excessive
involvement, low independence.
• Failure – belief one will fail in areas of
achievement.
• Entitlement/Grandiosity – belief superior to others,
entitlement, power, control.
• Insufficient self-control/Self-discipline – lack of selfcontrol/
frustration tolerance to reach goals.
• Subjugation – of needs, emotions, surrendering
control.
• Self-Sacrifice – excessive focus on meeting other’s
needs at own expense.
• Approval-Seeking/Recognition-Seeking –
excessive emphasis on gaining approval,
recognition, attention.
• Negativity/Vulnerability to Error – bias towards the
negative aspects of life.
• Overcontrol/Emotional Inhibition – excessive inhibition of
spontaneous action, feeling or communication.
• Unrelenting Standards/Hypercriticalness – high
internalised standards of performance.
• Punitiveness – angry, intolerant, punitive
around mistakes.

Question 9

Schemas are maintained through schema support, avoidance and compensation. What is involved in schema support?

Answer 9

Schema Support
• Cognitive Support
― Magnify information that supports
― Minimise information that contradicts
― Full range of cognitive distortions
• Behavioural Support
― Repeat, self-defeating patterns
― Adaptive and functional in early life
― Becomes problematic with age
― Person lives out the schema, affirming it’s truth.

Question 10

Schemas are maintained through schema support, avoidance and compensation. What is involved in schema avoidance?

Answer 10

Schema Avoidance
• Cognitive Avoidance
― Block thoughts and images
― E.g., Depersonalisation
• Affective Avoidance
― Block feelings
― E.g., Dissociation
• Behavioural Avoidance
― Avoid situations
― E.g., Agoraphobia,
social isolation

Question 11

Schemas are maintained through schema support, avoidance and compensation. What is involved in schema compensation?

Answer 11

Schema compensation
• Processes that overcompensate for EMSs.
• Attempts to “disprove” schema, by acting in opposite
direction predicted by schema.
• May be functional to a certain degree.
• However, failure to recognise
underlying vulnerability.
E.g., Princess Diana

Question 12

What is a good therapy progression with schema work?

Answer 12

• Case formulation of presentation and history in schema
terms.
• Identify 1-2 schema as initial targets.
• Distancing of schema via education.
• Reframe experiences when schema formed.
• Experiential techniques.
• Cartharsis, reframing, ventilation.
• Prompt cards – summary “calm thought”
• Confront Schema in therapy relationship.
• Alter schema in relation to family of origin.
• Pattern breaking – confronting self-defeating behaviours.

Question 13

What are the 4 techniques used to treat schema?

Answer 13

Emotive Techniques
• Increased awareness and labelling of emotional
experiences.
• Create imaginary dialogues with parents or significant
others.
• Parent-child re-scripting imagery.
• Teach mindfulness, emotional regulation and distress
tolerance.

Interpersonal Techniques
• Therapeutic relationship – transference issues.
• Explore links between early relationships and now and
how these are working.
• Therapist takes a re-parenting role.
• Teach interpersonal effectiveness skills.
• Group therapy experiences.

Cognitive Techniques
• Downward arrow technique.
• Review evidence on which schemas were built and
maintained.
• Examine evidence critically è new core belief.
• Discount early experience as reflecting
dysfunctional attitudes/behaviours.
• Historical test of new core belief.

Behavioural Techniques
• Develop rule-breaking tasks to challenge schema driven
behaviour.
• In-vivo exposure and behavioural experiments.
• Skills training if needed.
• Identifying and challenging self-defeating behaviours.