Who is Not Suitable for Schema Therapy?

By Jared Levenson - Reviewed on May 2, 2023
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Schema therapy is an innovative, integrative, and person-centered therapy that focuses on changing negative patterns and emotions to help clients improve their mental health.

It is a highly effective therapeutic approach that helps individuals struggling with chronic mental health issues such as depression, anxiety, trauma, borderline personality disorder, and other pervasive mental health issues.

However, like any other psychological intervention, schema therapy is not suitable for everyone.

Although it is a well-tailored approach to helping people overcome their emotional difficulties, it may not be the right match for everyone seeking it.

Our “Online Mental Health Reviews” team is a group of experienced mental health professionals with extensive knowledge and expertise in various areas of mental health, including schema therapy (but primarily Internal Family Systems therapy).

Our team of therapists and psychologists is dedicated to providing useful and evidence-based information to help individuals struggling with mental health issues find the care they need. We have a deep understanding of how online therapy delivers mental health treatments and how different approaches can help address specific disorders.

In this blog, we will discuss who is not a good candidate for schema therapy and how to tell if it is not appropriate for an individual in a particular context.

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Who Is Not Suitable for Schema Therapy

1. People who are not ready to change:

Schema therapy requires some level of commitment and dedication from the clients. If an individual is not prepared to put in the effort required to change, they may not benefit from schema therapy. Schema therapy is not a quick fix. It takes time, patience, and practice to change negative patterns and beliefs, and it requires full participation and involvement from the client. 

2. People with severe mental illness:

Although schema therapy can be helpful for individuals with mental disorders such as depression, anxiety, or personality disorders, it may not be recommended for those who experience severe symptoms, such as psychotic or dissociative symptoms. Such individuals need more specialized treatment and support to stabilize their symptoms before undergoing schema therapy. 

3. People with a history of substance abuse:

Substance abuse can considerably affect an individual’s mental and physical health, leading to underlying issues that may hinder successful schema therapy. In such cases, it is generally necessary to undergo treatment and achieve sobriety before undertaking schema therapy.

This is similar to severe mental illness as well. For example, the author of this article worked for years at an eating disorder residential treatment center in the Bay Area.

Before therapy, we often had to re-feed anorexic clients, so they could be mentally and physically capable to participate in and learn from therapy.

4. People unwilling to reflect on their behavioral patterns:

Schema therapy requires individuals to reflect on their negative behavioral patterns and beliefs, acknowledge their weaknesses, and be open to new perspectives. If an individual is not ready to admit their behavior patterns and work on them, schema therapy may not be the best fit.

5. Individuals seeking a quick fix:

Schema therapy does not provide a quick fix for emotional difficulties. It requires time and effort to work through the negative schemas and beliefs that have been ingrained for a long time. If an individual seeks a quick solution without putting in the effort required, schema therapy may not be the best option.

If you’re struggling with difficult or recurring emotional problems, schema therapy may offer a solution. Schema or cognitive behavior therapy center is a type of psychotherapy that focuses on identifying and addressing the unhelpful or negative patterns of thinking, feeling, and behavior that can contribute to mental health issues. But what exactly is schema therapy, how does it work, and what benefits can it offer?

What is Schema Therapy?

  1. Schema therapy was developed in the early 1990s by psychologist Jeffrey Young to help people overcome long-standing and pervasive mental health issues, such as personality disorders and chronic depression.
  2. Schema therapy posits that negative or maladaptive patterns of thinking and feeling, called schemas, develop early in life and become deeply entrenched and automatic, leading to ongoing mental health problems.
  3. In schema therapy, the therapist works with the patient to identify these schemas and explore their origins and how they manifest in the patient’s thoughts, feelings, and behaviors.
  4. The therapist then works to replace these maladaptive schemas with healthy, helpful, and positive ones through a combination of cognitive, behavioral, and experiential techniques.

Schema therapy is a type of psychotherapy that focuses on identifying and addressing underlying maladaptive patterns of thinking and behavior, known as schemas. These schemas develop during childhood and are repeated over time, shaping perceptions and behaviors that can become problematic in adulthood.

Schema therapy aims to identify these schemas and their triggers to develop coping mechanisms and promote long-term behavioral change.

How Does Schema Therapy Work?

During Schema Therapy, a certified therapist will help you identify and understand your negative schemas’ core beliefs.

Then, they will help you challenge and restructure these thoughts and beliefs by providing you with different techniques and exercises.

A few of the main techniques used in Schema Therapy include:

  • Schema Mode Work: This technique involves identifying the different modes of your personality and learning how to balance them.
  • Reparenting: This technique involves revisiting past traumas and learning how to nurture yourself as a child.
  • Imagery Work: This technique involves using your imagination to change negative patterns of thought or emotion.

How does Schema Therapy help in treating mental health issues?

Schema Therapy has proved effective in treating numerous mental health issues, including anxiety, depression, personality disorders, addictions, and post-traumatic stress disorder.

The therapy uses different techniques such as cognitive, behavioral, experiential, and interpersonal techniques, to make an individual aware of the thoughts, feelings, and behaviors linked to their schemas.

Once these schemas are identified, the therapy works on developing healthy coping mechanisms and positive self-reinforcement.

Advantages of Schema Therapy

One of the significant benefits of Schema Therapy is that it targets deep-rooted maladaptive patterns of thinking and behavior that often go unnoticed in other forms of therapy. Other benefits include:

  • Long-term improvement: Schema Therapy focuses on long-term improvement through the development of healthy coping mechanisms that help individuals maintain a positive change.
  • Addressing treatment resistance: Schema Therapy is designed to identify and address treatment-resistant issues, providing an alternative in cases where other therapies have not proved effective.
  • Developing healthy relationships: Schema Therapy helps individuals develop healthy relationships with themselves and others by addressing negative self-talk and maladaptive interpersonal styles.

What Are the Drawbacks of Schema Therapy?

Schema therapy is a form of psychotherapy that helps individuals explore and address unmet core emotional needs resulting from the inability to develop healthy coping strategies.

However, there are some drawbacks to schema therapy that you should be aware of.

Perhaps the most significant criticism or drawback of schema therapy is how new the treatment is in the field of psychology.

There is limited research on the long-term effectiveness of schema therapy, and it’s not clear whether it leads to reduced maladaptive schemas and symptoms across all mental health disorders.

Additionally, fewer therapists practice Schema Therapy so you might not be near a Schema therapist.

With fewer Schema therapists in comparison to Cognitive Behavioral therapists, prices are generally higher as well.

If you are limited financially, you may want to browse the Reddit comment section for tips to find cheap online therapy.

Who is Suitable for Schema Therapy?

Schema therapy is a form of talk therapy that focuses on identifying patterns of behavior and thoughts that may be perpetuating mental health conditions. It is an integrative approach that combines aspects of cognitive-behavioral therapy, attachment, and object relations theories.

If you’re wondering if schema therapy might be right for you, the answer is that it depends on your specific needs and goals. This type of therapy is typically most effective for individuals with long-standing, distressing issues that are deeply rooted in childhood experiences.

You may want to take a free online mental assessment to learn more about your mental health profile.

Is Schema Therapy right for you?

Schema Therapy is one of the many treatment options available for mental health issues. Individuals with long-standing treatment-resistant issues or underlying deep-rooted patterns of thinking and behavior may benefit from Schema Therapy.

Most likely you’ll benefit from Schema Therapy if you are already mentally stable, and are more inclined to self-wisdom and self-knowledge. This approach to therapy is more nuanced in many ways, slower-paced, and also oriented toward your body and understanding your past.

What Are the Benefits of Schema Therapy?

Schema therapy can be effective in treating a wide range of mental health issues, including personality disorders, chronic depression, anxiety disorders, and substance abuse.

It can also be effective in helping people overcome the negative impacts of childhood experiences such as abuse, neglect, or trauma.

The long-term approach of schema therapy can also help people develop greater insight into their thought processes and behaviors, leading to greater self-awareness and the ability to make lasting changes in their lives.

A systematic review of the evidence base for Schema Therapy1 concludes, “demonstrates clinically effective outcomes in a small number of studies and that would benefit from ongoing research and development”.

Next Steps

If you are interested in exploring schema therapy, the first step is to talk to your healthcare provider or mental health professional to see if it may be a good fit for you. They can help you identify a therapist who is experienced and qualified in schema therapy.

Additionally, you can find resources for schema therapy and other mental health resources through professional organizations such as the International Society for Schema Therapy (https://www.schematherapysociety.org/).

Remember, schema therapy can be a powerful tool for overcoming pervasive and long-standing mental health issues. By identifying and replacing maladaptive schemas, you can cultivate greater self-awareness, healthier thoughts and behaviors, and a more fulfilling life.

You may research nearby skin-picking therapists, doctors, and specialists, their locations, and their insurance coverage with just one simple search on Zocdoc.

What Are the Different Schemas in Schema Therapy?

If you are struggling with mental health issues, particularly long-standing and pervasive issues, schema therapy may be a viable solution.

This type of psychotherapy primarily deals with negative or maladaptive patterns of thinking and behavior that can lead to mental health concerns. There are different schemas in schema therapy, and each one serves to address the varied ways these negative thoughts and feelings can manifest in individuals.

Here are some of the different schemas in schema therapy:


This schema often stems from early childhood negative experiences, including separations, neglect, and family instability. Individuals with this schema may experience ongoing feelings of inadequacy, anxiety, and mistrust. They can also tend to go to great lengths to avoid rejection.

Emotional Deprivation

This schema involves the feeling that emotional needs will never be met or understood. An individual with this schema may feel emptiness and loneliness, as they struggle to effectively connect with others.


This schema revolves around the belief that there is something uniquely wrong with an individual or that they are inherently unworthy of love and acceptance. Those with this schema may feel unlovable or constantly self-critical, leading to strong feelings of shame.

Social Isolation/Alienation

This schema involves feeling like an outsider or like one doesn’t belong. It leads to a sense of social disconnection and emotional distance from others, prompting individuals to avoid social situations altogether.


This schema can make someone feel helpless or incapable of making decisions on their own. They may struggle with decision-making, and as such, they may become overly dependent on others.

Vulnerability to Harm or Illness

Someone with this schema may have an ongoing sense of danger or that they are at risk, leading to worry or maladaptive behavior such as hypervigilance or avoidance.

Unrelenting Standards/Hypercriticalness

This schema revolves around the belief that one can never be good enough, and as such, they avoid criticism or rejection by being overly critical of themselves or others.

Remember, schemas are unique to each individual, and many people may have several schemas that manifest simultaneously. Schema therapy aims to help individuals identify and tackle these negative schemas through techniques such as cognitive restructuring, experiential interventions, and behavior change strategies.

Types of Early Maladaptive Schemas

Early Maladaptive Schemas (EMS) are deeply ingrained patterns of thoughts, emotions, and behaviors that develop during childhood and can impact our lives in significant ways.

They are persistent and negatively impact how we perceive ourselves, the world, and our relationships with others. If left unaddressed, they can cause severe distress and problems in our personal and professional lives.

There are different types of early maladaptive schemas. Here is a brief explanation of some of the most common ones:

Abandonment/Instability Schema

This type of schema is characterized by a fear of being abandoned or losing someone we are dependent on. People with abandonment/instability schema may display clingy behavior or become overly dependent on others.

Mistrust/Abuse Schema

Individuals with this schema carry deep-seated feelings of mistrust towards others and may have experienced some form of emotional or physical abuse during childhood. They tend to scrutinize people’s motives and often interpret others’ actions as harmful or threatening.

Defectiveness/Shame Schema

People with this schema feel they are inherently flawed, inferior, or not good enough. They tend to have high expectations of themselves and fear that others will reject them for their perceived shortcomings.

Subjugation Schema

This schema is characterized by a tendency to submit to the desires of others to avoid conflict or criticism. Individuals with this schema do not express their true feelings or needs and may stay in negative or abusive situations.

Self-Sacrifice Schema

People with this schema tend to prioritize the needs of others over their own. They feel a sense of obligation to take care of others at the expense of their well-being and may have difficulty setting boundaries.

These schemas can manifest in various ways, such as anxiety, depression, relationship issues, and low self-esteem. However, recognizing these schemas is the first step in addressing them. With therapy, individuals can learn to identify negative patterns, reframe their thinking, and develop coping mechanisms.

If you are struggling with any of these schemas, seeking professional help from a mental health expert is highly recommended. They can provide tailored strategies to address your specific needs and improve your overall well-being.

Talkspace offers quality online therapy services for adults, teens, and couples along with a medication program. Over 40 million Americans may use Talkspace and get their mental health care costs covered through insurance.

Talkspace offers over 5,000 therapists, and Talkspaces gives you a greater degree of therapist choice and selection in comparison to other online therapy providers.

Types of Emotional/Mental Issues Addressed by Schema Therapy

Schema therapy is a form of talk therapy that helps people identify and change unhelpful patterns of thinking and behavior that cause emotional and mental distress.

It is a holistic approach that integrates elements from cognitive-behavioral therapy (CBT), attachment, and object relations theories.

What issues can Schema Therapy address?

Schema therapy, what is it and how can it help you?

Schema therapy has proven to be effective in treating a wide range of emotional and mental health issues, including but not limited to:

  1. Personality disorders: Schema therapy is a highly effective treatment for personality disorders, such as borderline personality disorder, narcissistic personality disorder, or avoidant personality disorder.
  2. Depression and Anxiety: Schema therapy can help people struggling with depression and anxiety by addressing the maladaptive thoughts, beliefs, and behaviors that contribute to their symptoms.
  3. Eating Disorders: Schema therapy has proven to be useful in treating eating disorders like bulimia, anorexia, and binge-eating disorder.
  4. Childhood Trauma: Schema therapy can be an effective tool for treating individuals who experience childhood trauma, abuse, or neglect.

How can Schema Therapy help?

Schema therapy can help people by addressing the root cause of their emotional and mental health issues. It helps individuals challenge their deep-rooted beliefs about themselves and their relationships with others.

Schema therapy also teaches skills and strategies to overcome negative thinking patterns, improve self-esteem, manage emotions, and cope with stress.

What to expect during Schema Therapy?

Schema therapy typically involves weekly sessions for a period of several months to a year or more, depending on the individual’s needs. During the therapy, the therapist works with the individual to identify and understand their schemas or negative patterns of thinking and behavior. Then, the therapist helps the individual to challenge and replace those schemas with more helpful and positive patterns.

Practical Tips

If you are considering schema therapy as a treatment option, it is essential to work with a licensed and experienced therapist.

  • Additionally, you should be prepared to commit to weekly therapy sessions and do the homework assigned by your therapist.
  • Furthermore, it is not uncommon to experience discomfort and challenges during the therapy process since you are working to challenge deep-rooted beliefs about yourself.
  • Finally, it is important to practice self-care and seek support from loved ones to help manage the stress of therapy.

In summary, schema therapy is an effective treatment for a broad range of emotional and mental health issues.

Through talk therapy and practical strategies, it helps individuals to identify and change harmful patterns of thinking and behavior, leading to improved emotional and mental well-being.

Can Schema Therapy Help With Anxiety, Depression, and Personality Disorders?

Schema therapy is an effective treatment for managing and overcoming anxiety, depression, and personality disorders. Researchers have found that it can help individuals to:

  • Overcome negative patterns of thought and behavior
  • Improve interpersonal relationships
  • Increase self-esteem and self-awareness
  • Develop a better understanding of their emotions

Are There Any Side Effects?

Most individuals undergoing Schema Therapy experience no negative side effects. However, some may experience temporary discomfort as they challenge their negative schemas.

The Importance of Seeking Professional Help

If you believe that Schema Therapy could be a helpful treatment option for you, it’s essential to speak to a certified therapist or doctor.

A trained professional will be able to help you determine if Schema Therapy is right for you and develop a personalized treatment plan that meets your specific needs.

To learn more about Schema Therapy, please review the additional resources below:

  • Schema Therapy Services UK (source)
  • Understanding Schema Therapy – The Schema Therapy Institute (source)
  • Schema Therapy: Everything You Need to Know (source)


Schema Therapy is an effective treatment option for mental health issues that have been resistant to other forms of therapy. It works by targeting long-standing maladaptive patterns of thinking and behavior and developing healthy coping mechanisms.

Seeking the advice of a licensed mental health practitioner is crucial in determining if Schema Therapy is the right option for you.

With Schema Therapy, you can gain a deeper understanding of yourself and develop the tools necessary for long-term improvement in mental well-being.

Finally, our team at Online Mental Health Reviews has relevant articles you may want to learn more about, such as: who is appropriate for schema therapy, where is schema therapy near me, schema counseling training, schema therapy techniques, and the schema free questionnaire.

Our team would love to hear from you too! Tell us what mental health software to review next on Online Mental Health Reviews. If you have stories about using a particular product or know of a discount code, please share so everyone may benefit!

Best Value-Per-Dollar
BetterHelp | Online Therapy for Stressed Professionals
$60-$90 / Week

Overall, BetterHelp conveniently provides busy professionals with various live therapy options to make it the best online therapy in terms of value per dollar.

Try 10% Off Our Review


  1. Masley, S. A., Gillanders, D. T., Simpson, S. G., & Taylor, M. A. (2012, September). A Systematic Review of the Evidence Base for Schema Therapy. Cognitive Behaviour Therapy, 41(3), 185–202. https://doi.org/10.1080/16506073.2011.614274

If You’re In An Emergency

If you are experiencing a crisis and cannot wait for an online therapy appointment, it is essential to seek immediate help. Call 911 if you or someone else is in danger. If you are having suicidal thoughts, please call the 988 Suicide and Crisis Lifeline by dialing 988. This line is available 24/7 for those who need immediate assistance. Another option is to call the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 800-662-HELP (4357). This free and confidential service can provide you with information about treatment options and connect you with resources, available 24 hours a day, 7 days a week.

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