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New Developments in Schema Therapy

by Arnoud Arntz, Eshkol Rafaeli & Chris Lee

Presentation 1: Theoretical model for an extended taxonomy of schema modes that is applicable across cultures by Arnoud Arntz


The last decades Schema Therapy (ST) has become popular around the world. The model of psychopathology that underlies ST is based on the assumption that when basic emotional needs are insufficiently met in childhood, there is an increased chance that maladaptive schemas develop that can underlie personality pathology. Furthermore, the theory states that when such early maladaptive schemas are triggered, the individual can switch into a specific emotional-cognitive-behavioral state (called schema mode), depending on how the individual copes with the schema activation. Young proposed three maladaptive ways of coping with schema activation: surrender (where the activated schema rules the state of the person); avoidance (where avoidant strategies rule the person); and overcompensation (where believing that the opposite of the schema is true rules the person). An international workgroup is devising a new questionnaire to assess the most important schema modes, which will be validated internationally - so that from scratch on the instrument will be reliable and valid across cultures.

This presentation offers an overview of the project, which started with a fundamental reconsideration of the basic emotional needs of children and adults, and a strict application of Young's theory of coping with schema activation. Based on Dweck's analysis of fundamental needs it is argued that an important need has been overlooked in ST: that is the need of a coherent self- and world view. Also, the international workgroup felt that the need for fairness (justice) was overlooked. The resulting schemas and schema modes will be discussed, and specific attention will be paid to the confusion so far between temperament and ways of coping with schema activation.

Presentation 2: Digging deeper: Exploring the concept of modes by Eshkol Rafaeli


In this talk, Eshkol will discuss how the the concept of modes - cohesive, experientially distinct, state-like manifestations of personality characterized by specific profiles of co-activated affects, behaviors, cognitions, and desires – is central to the theory and practice of schema therapy. He will describe recent work (Lazarus & Rafaeli, in press; Lazarus et al., 2020) where he and his colleagues have argued that modes can serve as the basis for a transdiagnostic approach to psychopathology. This talk will then link the notion of modes to longstanding theoretical and empirical traditions, including philosophical accounts of selfhood, developmental psychology, social and personality psychology, and diverse psychotherapy models which lay the foundation for this mode-based approach to psychopathology. It will include examples of the approach’s explicit or implicit relevance to several classes of psychopathology, including dissociative, trauma-related, mood, anxiety, obsessional, substance, psychotic, and personality disorders. Finally, it will lay out a research blueprint for assessing and modeling modes, and present a broader research agenda highlighting intriguing empirical questions regarding modes in psychopathology.

Presentation 3: Examine the research that suggest from our existing items that assess schemas by Chris Lee


Chris will examine the research that suggest from our existing items that assess schemas, that there should be a number of additional schemas not listed in the current classification of 18 schemas. These include ‘Fairness/Justice’ and that some existing schemas are better classified as two schemas. ‘Emotional Inhibition’ is better conceived as ‘Emotional Constriction’ and ‘Fear of Loss of Control’ and Punitiveness is better regarded as either ‘Punitiveness to Self’ or ‘Punitiveness to Other’. This presentation will show how these schemas make sense in terms of client’s presenting issues. A scoring programme will be offered to assess these constructs.

About the Presenters:

Arnoud Arntz

Professor of Clinical Psychology at the University of Amsterdam, the Netherlands, with an affiliation at Maastricht University, the Netherlands. His main research interests lie in the fields of PTSD and personality disorders, both applied and fundamental. He also practices as a psychotherapist at PsyQ in Amsterdam, where he treats patients with trauma and personality disorders. Together with Adam Radomsky he was editor of the Journal of Behavior Therapy and Experimental Psychiatry.

His research focuses on psychological processes underlying personality disorders (PDs), especially borderline personality disorder (BPD), and anxiety disorders, especially PTSD; and their treatment. Using the approach of experimental psychopathology he tested psychological theories of anxiety disorders and PDs and contributed to the development of their psychological treatment. In developing and testing psychological theories and treatments he aims to connect basic research and clinical work. He is perhaps best known for his contributions to the development of Schema Therapy and Imagery Rescripting. He was project leader of the multicenter RCT that compared schema therapy (ST) to Transference Focused Psychotherapy as treatments of Borderline PD, and of another multicenter RCT that compared ST to treatment as usual (TAU) and CCT for 6 other PDs. Currently he is PI of an international RCT comparing working mechanisms of Imagery Rescripting and EMDR for PTSD that originated from childhood traumas, and together with Dr Joan Farrell PI of the international RCT that compares group-ST to TAU for Borderline PD. Professor Arntz also chairs a Dutch-German collaborative study investigating basic brain and cognitive processes in BPD and their change during treatment, which is associated with the international RCT on group-ST.

Eshkol Rafaeli

a professor of clinical psychology and the former director of clinical training in the psychology department and neuroscience center at Bar-Ilan University, Israel, where he directs the Affect and Relationships Lab. Prior to joining BIU, the lab and Eshkol were at Barnard College, Columbia University, where Eshkol continues to serve as a research scientist. Eshkol and his students study two key components of daily life – our affect and our relationships. In projects funded by the NIMH, ISF, BSF, the Templeton Foundation, the Hope & Optimism Initiative, and others, they’ve been examining the nature and structure of moods and emotions in the daily lives of both distressed and non-distressed individuals and couples. they look at the attempts partners make to make sense of each other’s thoughts, feelings, and needs, as well as at the interplay of good (supportive) and bad (hindering) actions that happen in the life of any couple. They also conduct psychotherapy/intervention studies, and are interested in the process and outcome of such interventions. He is a co-founder of the Israeli Institute for Schema Therapy, the co-author (together with David Bernstein and Jeffrey Young) of the 2010 Routledge book on Distinctive Features of Schema Therapy, and he continues to be very interested in using, teaching, supervising and researching this approach. 

Chris Lee

Associate Professor Christopher Lee works in private practice and has an adjunct appointment at the University of Western Australia. He is a certified trainer by both the international society of schema therapists and the EMDR international association. He conducts therapist training workshops on schema therapy and trauma treatments throughout Australia and overseas. He has published research on personality disorders, the assessment of schemas, and PTSD. He has received two International Society for Traumatic Stress Studies and EMDRIA awards for research excellence the first in 1999 and the most recent in 2019. In 2009 he also received the Inaugural Francine Shapiro award for research excellence conferred by the European EMDRIA. He was the 2011 recipient of the Australian Psychological Society’s Ian Campbell memorial award for contributions as a scientist-practitioner to Clinical Psychology in Australia. He is currently a principle investigator in two international multi-centred randomized controlled trials, one in treating complex PTSD and the other using schema therapy for Borderline Personality Disorder.

Why Schema Therapy?

Schema therapy has been extensively researched to effectively treat a wide variety of typically treatment resistant conditions, including Borderline Personality Disorder and Narcissistic Personality Disorder. Read our summary of the latest research comparing the dramatic results of schema therapy compared to other standard models of psychotherapy.

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