Towards a deductive approach for identifying maladaptive and salubrious schemas

Linking schemas to needs contribution to schema-oriented cognitive behavioral therapy

Abstract

Schema-oriented psychotherapy, located in the third developmental era of cognitive behavioral therapy, focuses on patients’ maladaptive schemas, developed through insufficient or inappropriate fulfillment of psychological needs, particularly during childhood. To date, schemas have been inductively identified through and for practical therapeutic work, and attention has thus been limited to maladaptive schemas. The current paper argues for a strictly theory-driven, deductive approach to the development of schemas, through which schemas are attributed to the core psychological needs from which they originate. This approach identifies both maladaptive and salubrious schemas, and highlights the role of other relevant schemas, as well as the association of each schema to a core psychological need. The paper is aimed at laying the theoretical groundwork for the relationship between schemas and basic need fulfillment, through which each schema can be attributed to the (adequate or inadequate) fulfillment of a particular core psychological need. In clinical practice, such an approach will facilitate a more nuanced understanding of patients’ disorders, in that it prompts clinicians to focus beyond patients’ maladaptive schemas and behaviors, thus identifying inadequately or unfulfilled needs, along with possible conflicts between or imbalances in the fulfillment of patients’ basic needs. This approach improves both patients’ and therapists’ understanding of and insight into the functionality of patients’ disorders, as it positively recontextualizes the functionality of a disorder or problematic behavioral pattern, as well as its underlying maladaptive schemas, in terms of the existential drive to fulfill fundamental human needs.