Understanding Schemas

Summary

An understanding of the individual, family, and cultural schemas is essential for patients to understand why and how they respond. An understanding of the schemas will explain patients’ past behavior, make sense of their present behavior, and help them to anticipate their future behavior. The major therapeutic task is help them identify the schemas, where they came from, what effect they have on their life, and how likely they are to change them.

The therapeutic steps are (1) the explication of the schemas based on the patient’s verbalizations, (2) exploration of the schemas to ascertain the value and power they have for the individual, (3) assessment of the thoughts and ideas that maintain particular schemas, (4) identifying and focusing on the attendant feelings and behaviors that derive from the schemas, (5) structuring specific interventions based on the patient’s idiosyncratic personal, family, and cultural schemas, and (6) structuring relapse prevention strategies to assist the patient in generalizing the therapeutic gain to other situations and occurrences. By confronting, disputing, or responding more adaptively to powerful, long-held schemas and to the emotional, affective, and cognitive sequelae of the schemas, we can begin to help the patient to move in more productive and coping directions.

These templates for understanding how people learn to understand their world are the essential ingredients in cognition, affect, and behavior. Schemas then become the main focus for all CBT.