Should I Undertake Schema Therapy Training? Considerations for Curious Therapists
Schema therapy is the heart and soul of my clinical and supervision practice. I’ve known schema therapy since my post-graduate trainings, where we had a copy of Reinventing Your Life in the student training clinic. Schema Therapy: A Practitioner’s Guide was one of my first big book purchases post-graduation and is the only book from that time I still refer to. The rest were donated many years ago.
Over the years, I moved beyond applying schema therapy or its principles with clients some of the time to delving deeply into it, achieving Advanced Certification as a therapist, and later completing my Supervisor Certification with the International Schema Therapy Society (ISST). During this time, I wrote an extensive collection of schema therapy blogs in simple language that help clients and therapists understand and apply schema therapy. I’ve also developed a number of trainings to support therapists to apply schema therapy with ease.
This year, I’ve had the pleasure of supporting clinical psychology trainees begin their journey with schema therapy in my part-time role as Lecturer/Clinical Supervisor. For some, the model feels more intuitive than others. It’s this experience and the questions I receive from current supervisees about schema therapy training that inspired me to write this blog.
The benefits of Schema Therapy
Developed by Jeffrey Young and colleagues by integrating the most effective components of other therapies such as CBT, psychodynamic therapy and Gestalt therapy, schema therapy has it all. And by all, I mean assessment and case formulation capacity, a relational focus, powerful emotion focused interventions, parts work (the mode model) and skills development for here and now change.
Of the many therapy models I have trained in, schema therapy is the only one that helped me understand and assess personality and its impact on the client’s presenting problems. I have yet to find a model that allows me to case formulate clients as well. Schema therapy also encourages and equips therapists to manage challenging personalities and at the same time promotes examination of the therapist’s schema and mode related activation. This can lead to enormous professional growth.
The downsides of Schema Therapy
The downsides of schema therapy could largely be summed up by “It’s complicated”. The schema therapy model is multi-faceted, and it can be challenging to learn. It is not unusual to hear that clients have done schema therapy in the past only to discover that very little of the model beyond assessment of schemas followed by cognitive challenging of those schemas. This is sometimes called the CBT plus approach. It is easy to understand how this happens as the components of schema therapy that have been integrated into schema therapy are what require the least adjustment of the therapist and can largely be achieved by reading the self-help book Reinventing Your Life.
Schema therapy is not a short-term therapy model that fits neatly into many of the funding models available to clients. This is because schema therapy was originally developed as a treatment for personality disorder. Schema therapy has since been adapted for clients with recurrent mental health disorders and persistent relational difficulties. These kinds of problems don’t usually resolve in 6-10 sessions.
How to determine whether Schema Therapy training is right for you
Completing schema therapy training requires a significant investment in time and money. I’ve seen many therapists waste both valuable time, money and in some cases lose confidence in their therapeutic ability by completing schema therapy training when the timing wasn’t right or when schema therapy isn’t right for the therapist.
Each therapist who asks me this question receives a response based on the following considerations that we review together.
their stage of career
where they currently work
the types of clients they work with and want to work with
how open they are to limited reparenting
how willing they are to be with strong emotion
I’ll walk you through why these factors play a crucial role in determining the right time to commence schema therapy training.
The stage of your career
Unlike my other favourite therapy EMDR, you can commence learning schema therapy in your early career. There are no requirements to be registered or licenced as a therapist prior to undertaking schema therapy training. However, if you want to certify in schema therapy it is essential that you meet the baseline requirements which does include university level qualifications and registration or licencing as a therapist. In fact, I first began learning schema therapy when I was in my Masters of Clinical Psychology program. I started with reading and implementing some concepts with the support of supervision. While it is probably best to wait until you feel solid in your core basic counselling and formulation skills before implementing schema therapy concepts, the benefits of beginning your schema therapy journey in early career is developing stronger case formulation skills and strategies to work beyond the here and now type approaches that are generally offered in Masters training.
Where you work
All therapies are better learned and mastered when you can practise them. Therefore, I advise you to consider whether you will be able to use schema therapy in full in your current workplace. If your workplace requires you to work in a solution focused, fast turnover approach, it may not be the right time to train in schema therapy. You may benefit from advanced conceptualisation of the impact of personality on problem development and maintenance, but you will be unlikely to practice the core skills of schema therapy.
Some work settings where schema therapy is very welcome and useful includes those that offer the potential long term therapy clients and clients who have long term, entrenched or recurrent difficulties in the area of mental health and relationship functioning. This can include private practices that attract clients with persistent difficulties, forensic facilities, community mental health and inpatient mental health treatment settings.
The clients you work with and want to work with
When considering training in schema therapy consider what sort of clients you work with currently and who you want to work with in the future. Do you have clients on your current caseload who would benefit from schema therapy? Given the benefits of practising schema therapy soon after training, if you have no capacity to offer schema therapy in the short term because, for the foreseeable future, your books are full of clients who are not suited to schema therapy, then consider delaying your schema therapy training until you will have the opportunity to do so. Perhaps start with reading core schema therapy texts (I’ve suggested my favourites at the end of the article).
Schema therapy was developed to better support clients with diagnosis of borderline personality disorder. It is well known in the therapeutic community for its role in treating clients who don’t respond to here and now approaches. For this reason, developing expertise in schema therapy can increase the complexity of the referrals you attract. If this is not welcome, either now or in the future, reconsider training in schema therapy.
If you want to work with clients who are suitable to schema therapy but don’t have space currently, start to make space for these types of clients as clients exit your care or create space for them.
How open are you to offering limited reparenting as the core ingredient of change?
For some therapists, the relational demands of the limited reparenting focus of schema therapy are uncomfortable or unwanted. Limited reparenting is the essential frame of schema therapy and often the one training therapists struggle with the most or reject in full. Some therapists are attracted to schema therapy due to the case formulation and intervention strategies but want to offer this without the essential framework of limited reparenting. When limited reparenting is not applied, then what is offered it is not truly schema therapy.
What is limited reparenting?
Limited reparenting is a core schema therapy approach in which the therapist provides a safe, consistent, and professionally boundaried relationship that offers elements of emotional nurturance, protection, guidance, and appropriate limit-setting that may have been insufficient in early life. This therapeutic experience helps clients access vulnerable emotions, challenge long-standing maladaptive beliefs and patterns, and develop healthier ways of relating to themselves and others. The ultimate goal is not to foster dependency, but to strengthen the client's Healthy Adult mode so they can increasingly meet their own emotional needs with self-compassion, resilience, and flexibility beyond therapy.
For therapists who want a more distanced therapy relationship, those who fear a breakdown in boundaries or who feel uncomfortable offering care to meet the client’s emotional needs through the therapeutic frame, limited reparenting can be a deal breaker. A sign that you may not be the kind of therapist suited to schema therapy is a sense of dread about the idea of providing nurturing care as a good parent would in session. Another common example, feeling very resistant to the idea of holding the imaginal hand of the client’s vulnerable child in as you lead the vulnerable child mode to safety in an imagery rescripting exercise when you are in the role of the Healthy Adult in the image. (Please note that physically touching your client in session is not a requirement of schema therapy and touching clients is generally not advised according to the AHPRA Code of Conduct for Psychologists).
If you want to get to a place where you feel comfortable offering limited reparenting in a boundaried way, I recommend seeking out supervision or therapy to increase your capacity to do so. Often, therapists feel uncomfortable with the limited reparenting frame due to their own history of core unmet emotional needs. It is difficult to offer what you did not receive.
How willing are you to work with emotion?
Schema therapy strongly advocated working with emotion and accessing emotions in the client’s vulnerable child mode. It features emotion-focused interventions including imagery rescripting and chair work. This means you need to be willing to move beyond the cognitive sphere and work experientially with clients as they experience strong, complex and sometimes old feelings.
Working with emotion tends to feel more unpredictable than working cognitively, and some therapists do not like this space due to feeling out of control.
If you are uncomfortable with clients who express emotion in session, and you want to become a schema therapist, this will be something you need to work on in your own therapy and in supervision.
If you don’t want to work with emotion and prefer cognitive or coaching approaches, schema therapy is not for you.
Final Thoughts
Schema Therapy is a powerful model of therapy when applied as intended. For those who embrace the model, it strengthens your case formulation skills and extends your capacity to work with increased complexity. Your ability to implement schema therapy can be impacted by a range of professional and personal factors. Before training in schema therapy through a formal training program, I highly recommend getting a baseline of knowledge by reading one or all of the following books*:
Creative Methods in Schema Therapy. Advanced and Innovations in Clinical Practice: This book has an excellent chapter on assessment and formulation that is easy to grasp and implement, plus helpful guidance for key interventions.
Schema Therapy: A Practitioner’s Guide: the original schema therapy guide is hard to beat for a complete and thorough guide to understanding and practising schema therapy and is co-written by founder Dr Jeff Young.
Schema Therapy in Practice. An Introductory Guide to the Schema Mode Approach: This book is a helpful starter guide to working with modes and will support you to extend the practice of schema therapy beyond borderline personality disorder to other personality disorders and Axis I disorders such as anxiety, depression and OCD.
Reinventing Your Life: A self-help book that focuses on healing schemas, is a great starter place for therapists looking for an introduction to the model.
I do not receive affiliate income from Amazon for recommending these books.
Nadene van der LInden is a Clinical Psychologist, EMDRAA accredited EMDR Consultant & Therapist, ISST Certified Advanced Therapist and Supervisor in Schema Therapy and Psychology Board Approved Supervisor.
