Last development and evolution of the Therapy scheme

Almost thirty years have passed since the first manualization of the Therapy scheme approach (1999) by its creator Jeffrey Young.

Throughout this time they have been made additions, insights and evolutions of the model.

Despite this, fundamental constructs remain such as basic needs, early maladative schemes, fashions and the role of limited repairing in the therapeutic relationship.

But let’s go in order.

The origins of the model

There Therapy scheme It was born as an integrated model following the awareness that the only cognitive therapy was not effective for a high number of patients, especially for those with pathological aspects of the personality.

Thus developed the idea that fundamental emotional needs frustrated in childhoodcould give rise to early dysfunctional schemes, to which the patient responds with dysfunctional coping styles.

The treatment was (and is still) aimed at modifying the schemes and coping styles and the satisfaction of the previously frustrated emotional needs.

The change takes place thanks to the reconnection to emotional needs, the healing of the patterns, the use of more functional coping strategies and the construction of healthy adult mode.

All this through theIntegrated use of cognitive, behavioral, experiential techniques and therapeutic relationship.

The new needs and maladative schemes

As for the key constructs of the model, the expansion suggested by some authors (Arrntz et al. 2021; Bach et al., 2018) concerned the addition of other basic needs to those already theorized by Young.

This list was also reached thanks to the comparison and identification of overlaps with the Proposals of DEWck (2017).

The complete list is established as follows:

1. Security and nourishment (including safe attachment);
2. Autonomy competence and sense of identity;
3. Freedom of expression needs, emotions and emotions;
4. Spontaneity and play;
5. Realistic and self -control limits;
6. Self -consistency. When it is not possible to develop significant, profound social connections and when the person lacks a sense of rooting and integrity, it is likely that the development of consistency of the self and the world is lacking;
7. Justice. When this need is not satisfied, the child perceives lack of equality, a sense of injustice and guilt. Often there can be victimization or bulization and one’s point of view cannot be expressed;
8. Connection with naturewhose frustration implies a failure to connect with the environment and the surrounding place.

The latter three needs are those recently proposed by the various authors and are associated respectively a New maladative schemes:

• M; anchor of a coherent identity. In which there is a feeling of inability to express one’s point of view and ideas, as well as an emotional superficiality.
• Lack of a significant world. The person feels he lived disconnected from others and from the world with a sense of emptiness and lack of meaning.
• Injustice. The other lived as a executioner. The perception is of constant victimization with the pretense that the other systems are things.
• Lack of connection with nature. They are individuals who lack the relationship with nature, often materialistic.

The expansion thanks to the construct of fashions

As for fashions, due to the enormous complexity in dealing with some patients who had active, even at the same time, several patterns, the model was expanded using this new construct.

Using a metaphor borrowed from the field of genetics, if the patterns are genotype, fashions are the phenotypic expression and the operations linked to them.

These are the multiple parts of the self observable in the here and now, resulting from the intersection of the active scheme at that moment and from its coping response.

Initially ten fashions were conceptual, but with the growing complexification they became about forty (Arntz et al., 2021) listed in the following paragraph.

The new coping fashions and style

In general, as regards fashions, there is the tendency to stress the idea that they are the combination between the activation of a specific scheme and the coping mode that the person puts in place to manage the scheme itself.

Arnotz and collaborators (2021) tried to reduce the latest list of fashions, reaching a number of forty, divided between child fashions, parental fashions, avoidant fashions (in which the compliant surrender is also included first included in the style of surrender) and fashions of reversal.

Below is the list translated into Italian, with some short descriptions, from which everyone’s function can be easily understood. The “N” indicates the new fashions:

Child fash

• Neglected child
• Non -autonomous child
• Subordinate child (N).
• Forced/obliged child (N), as he has not been allowed to satisfy the needs of play and spontaneity.
• Confused child (n)
• Excessively diligent child (N)
• Child victimized (n)
• Great child
• Spoiled child (n)
• Unruly child
• Impulsive child
• Angry baby
• Infuriated baby
• Rebel child (N)
• Gruntolone child (N)

Parental fashions

• Demanding critic
• Punitive

Fashions of avoidance

• Detached protector
• Funny protector (N). It is the mode that has the function of avoiding hiding or masking the painful emotions that derive from the frustration of needs.
• Angry protector
• Avoidant protector
• Compliant surrender
• He who seeks reassurances (N). Very present in anxiety disorders, it refers to those who asks for confirmations or others.
• Detached self -consolator
• Suspicious hypercontrollant

Reversal fashions

• Hyperautonomo (N). It refers to the activation of that part that leads to do and manage everything alone, without asking for help from others.
• Clown (n)
• Research of attention and approval
• Self -financer
• Bully and attacker
• Ipercontrollante perfectionist
• Idealizer (N). Who tends to mystify others.
• Dethery (N). It refers to an imprudent person who likes to do dangerous things.
• Fannullone/Oblomov (N). A lazy, not very strong -willed or procrastin individual.
• Pollyanna/Too much optimistic (N). A person excessively cheerful or positive.
• The merciful (n). Who is always charitable, Clemente, Benigno.
• The humble (n)
• The impostor (N)
• The scammer/manipulator (N)
• The predator

Coping styles

In addition, a change from the original model concerns the coping style.

Coping fashions would all return to Avoiding styles and hypercompensation (now called inversion). While in the style of surrender there are the child fashions and punitive critical parent.

In the latter style that is renamed “resignation”, attention is paid more to the concept that the person, in fact, surrenders to the active scheme and perceives, through one cognitive and emotional fusionall the message conveyed.

Consequently, the behavior is also coherent. For example, a patient with a scheme of inadequacy firmly believes that there is something wrong with him, perhaps by engaging in relationships in which the partner is critical, as he believes he does not deserve better.

The importance of healthy adult mode

Like most third generation approaches, such as Compassion Focused Therapy (Gilbert, 2016) and Acceptance Committment Therapy (Harris, 2021), which have given greater emphasis to work on resources, on healthy parties and on the development of a responsible attitude of a good self -regulation, even the Therapy scheme was no less.

This approach has always supported the importance of two healthy fashions (healthy adult and happy child), but in the latest developments it has further expanded attention and, consequently, the techniques useful for the growth of these parts.

In particular, theHealthy adult It can be developed both as a pervasive attitude to be taken in living one’s life, and as part to access in moments of emotional difficulty. Strengthening and connecting to the healthy adult mode implies the development of four fundamental skills:

1. The awareness, to be developed through car exercises and the search for an attitude mindufulness, that is to notice without judging what is happening.
2. The self -compression, i.e. the growth or construction (where absent) of an attitude aimed at understanding and validating pain and wanting to alleviate it.
3. Recognize dysfunctional cognitions and learn to differentiate them from reality. Parallel to support healthy representations.
4. Finally, the exposure for behavioral change. All the previous work must be corroborated by actions that confirm the internal change.

Develop the healthy adult It implies entering you in contact as frequently and quickly possible to assume its perspective, make choices or actions that can develop its needs and take actions consistent with this.

Clinical applications

The Therapy scheme is a very expendable model in the clinical field. The reasons concern the comprehensibility of the reference theory, to which patients and therapists can easily report in a shared context.

In fact, the emphasis on the constructs of basic needs, patterns, coping strategies and how these develop and support psychopathology give an overall vision compared to other models.

Also, theimportance of the conceptualization of patients through fashions It allows the latter to be able to reason (metacognitively) on their functioning from a different, more lucid and self -regulated perspective.

Finally, the integration of the different techniques available allows to respond to obstacles to change in a diversified and consistent way with the type of patient who requires therapeutic help.

Bibliography

• ARNTZ, A., Rijkeboer, M., Chan, E., Fassbinder, E., Karaosmanoglu, A., Lee, C., W., Panzeri, M. (2021). Reformulated Theory Underlying Towards Therapy Scheme: Position of an international workgroup. Cognitive Therapy and Research.
• B, Lockwoodb. G. and Young, J. (2017). A New Look at the Schema Therapy Model: Organization and Role of Early Maladaptiva Schemas. Cognitive Behviour Therapy
• Brockman, R., Simpson, S., Hayes, C., Van der Wijngaart, R. & Smou, M. (2025). Practical guide to the Therapy scheme. Assessment, techniques, treatment strategies and specific applications. Erickson, Trento.
• DWEK, CS (2017). From Needs to Goals and Representations: Foundations for A Unified Theory of Motivation, Personality and Development. Psychological Review124, 689–719
• Harris, R. (2021) Make act. A practical guide for professionals at the Acceptance and Commitment Therapy. Franco Angeli.
• Gilbert (2016). Therapy focused on compassion. Distinctive features. Franco Angeli.
• Young, J. (1999). Cognitive Therapy for Personality Disorders: A Focused Spel Scheme. Sarasota, FL: Professional Resource Press.