Schema Therapy is an integrative psychotherapeutic approach developed by Dr. Jeffrey Young, originally designed for personality disorders and chronic psychological difficulties that had not responded adequately to shorter-term treatments such as CBT. It has since been validated for a broad range of complex presentations and is now one of the most evidence-based treatments available for borderline personality disorder, other personality disorders, chronic depression, and complex trauma.
Schema Therapy integrates elements of cognitive-behavioral therapy, attachment theory, gestalt therapy, and object relations — within a unified framework centred on the identification and transformation of early maladaptive schemas and schema modes.
Early maladaptive schemas are deep, pervasive patterns of thought, emotion, and experience that develop in childhood and adolescence in response to unmet core emotional needs — for safety, acceptance, autonomy, self-expression, or appropriate limits. These schemas are self-perpetuating: they shape how a person perceives situations, feels, and behaves — in ways that were once adaptive responses to early experiences but have become obstacles to functioning and wellbeing in adult life.
Common schemas include abandonment and instability, mistrust and abuse, emotional deprivation, defectiveness and shame, social isolation, dependence, vulnerability to harm, self-sacrifice, unrelenting standards, and entitlement.
Schema modes refer to the moment-to-moment emotional states and behavioural responses activated by schemas — the vulnerable child, the angry child, the detached protector, the inner critic, or the healthy adult. Schema Therapy works with these modes directly — developing the healthy adult mode and reducing the dominance of maladaptive ones.
Schema Therapy has a strong evidence base for borderline personality disorder, narcissistic and Cluster C personality disorders, chronic depression, eating disorders — particularly where deep shame and self-criticism are central features — complex PTSD and childhood trauma, and relationship difficulties rooted in early attachment patterns.
Schema Therapy is particularly indicated for presentations that have not responded adequately to shorter-term approaches — where difficulties are longstanding, deeply embedded, and clearly connected to early experiences.
Cognitive techniques help the patient understand the origin of their schemas, examine the evidence for and against them, and develop more adaptive beliefs and perspectives.
Experiential techniques — including imagery rescripting, chair work, and limited reparenting within the therapeutic relationship — work directly with the emotional dimension of schemas, accessing and processing experiences that purely cognitive approaches cannot reach.
Behavioural pattern-breaking involves identifying the coping responses that perpetuate schemas — avoidance, surrender, or overcompensation — and developing new, healthier behavioural patterns.
The therapeutic relationship itself is a central instrument of change in schema therapy. Within appropriate professional limits, the therapist provides what the patient did not receive in childhood — attunement, validation, empathy, and consistent presence.
Schema Therapy at IsraClinic is conducted directly in English, Russian and Hebrew — without an interpreter. The experiential depth of schema work — imagery, emotional processing, and relational work — requires direct linguistic and cultural communication.
Schema Therapy is delivered within an integrated clinical framework. Where pharmacotherapy is also involved, the schema therapist and treating psychiatrist work in close coordination.
Schema Therapy may be combined with DBT in presentations where both approaches are indicated — DBT providing skills and behavioural stabilisation, schema work addressing the deeper structural patterns at a subsequent or parallel stage of treatment.
All Schema Therapy at IsraClinic is delivered within the framework of the Psychoergonomic Method — ensuring the approach is built around this specific patient's schema profile, history, and clinical needs.
Schema Therapy is indicated when difficulties are longstanding, deeply embedded, and connected to early experiences — and when shorter-term approaches have not produced sufficient change. It is the treatment of choice for personality disorders and complex presentations.
Standard schema therapy is conducted on a weekly basis over approximately one to one and a half years. Complex presentations — particularly severe personality disorders — may require a longer course. The treating team will discuss realistic expectations at the outset.
All three are evidence-based treatments for personality disorders and complex presentations. They differ significantly in their focus, mechanisms, and the kind of work they require from the patient.
DBT focuses on the present — on managing emotional crises, building distress tolerance, and developing concrete interpersonal skills. It asks: what do you do when emotions become overwhelming? DBT teaches skills and provides a structured framework for behavioural stabilisation. It is the most appropriate starting point when safety, self-harm, and emotional crises are the central clinical concern.
Schema Therapy focuses on origin — on understanding where the patterns came from and healing the unmet emotional needs that generated them. It asks: what happened in early life that created these patterns, and how can they be transformed? Schema work is experiential as well as cognitive — it uses imagery, chair work, and the therapeutic relationship itself as instruments of change. It is most appropriate when difficulties are longstanding, deeply embedded in personality, and clearly rooted in early experience.
Transference Focused Psychotherapy (TFP) focuses on the therapeutic relationship itself — on the moment-to-moment patterns that emerge between patient and therapist as a window into the patient's deeper relational world. It asks: what is happening right now, between us, that reflects the patterns you carry? TFP uses interpretation of transference as its primary instrument of change. It is particularly indicated for identity disturbance, splitting, and borderline and narcissistic presentations where these relational dynamics are central.
In clinical practice, these approaches are not mutually exclusive. DBT and schema therapy are frequently combined — DBT providing stabilisation, schema work addressing deeper structural change. TFP is typically a longer-term commitment and most appropriate when the patient has sufficient psychological stability to work intensively with the relational dimension.
The treating team at IsraClinic will assess which approach — or which combination — is most appropriate for each individual patient's presentation, goals, and stage of treatment.
IsraClinic accepts patients for in-person consultation in Tel Aviv and online, in English, Russian and Hebrew. No referral is required.
Clinical Programme Curator: Valery Kravitz | IsraClinic | Last reviewed: 2026
Schema Therapy works with the deepest patterns — the ones that have been there since childhood. If you would like to discuss whether it is right for your situation, our team is available in English, Russian and Hebrew.