The simple answer to this question is yes. Schema therapy tends to be initiated once CBT has not been successful for patients and includes some elements of CBT. Let’s get into what each therapy entails and exactly what the difference is.
CBT (Cognitive Behavioral Therapy)
CBT is a popular form of psychotherapy that examines the relationships between thoughts, feelings, and behaviors. Its purpose is to help people overcome emotional problems, make patients aware of automatic thoughts, and how those automatic thoughts affect how patients feel and behave.
The psychiatrist and patient work together to expose patterns of thinking and determine the best ways to positively change those patterns. Because CBT is an active intervention, the patient should expect homework and practice outside of therapy. CBT emphasizes changing the ways people think in order to improve their moods.
Schema Therapy (ST)
Schema therapy combines CBT, gestalt, imagery and other techniques to help weaken the maladaptive schemas and coping styles and re-build the patient’s healthy side. In a sense, schema therapy works with the patient’s inner child to help correct the emotional difficulties experienced during childhood in a strong effort to change them.
Schema therapy doesn’t simply target feelings of depression or anxiety; it works to rectify past emotional disturbances and change long-term patterns.
While schema therapy combines elements of CBT, these elements are often practiced later. The purpose of schema therapy is to bring to light schemas suffered by a patient during childhood that have entrenched themselves in their adult life.
In CBT, recognizing automatic thoughts and how they make patients feel and behave is sufficient. However, in schema therapy, the focus is to do all of the above while changing the schemas so that they are no longer a hindrance to the patient’s adult life.
To Your Mental Health,
Scott Shapiro, MD, FAPA