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Critiques of Schema Therapy
Jim Pretzer · 11/04/01 at 10:04 PM ET
I can't think of any critiques of Schema Therapy except for a few published in obscure newsletters which you would have a hard time locating so I'll list a few criticisms which I've encountered (these comments do not all represent my own views): 1. Some established Cognitive Therapists (Jackie Persons and Chris Padesky, I believe) have argued that by focusing so whole-heartedly on schemas, Jeff's approach risks underemphasizing interventions which focus on achieving immediate changes in automatic thoughts and in behavior. If this occurs, it should delay symptomatic relief without increasing the effectiveness of therapy. They (and I) would argue in favor of Beck's approach which focuses on working towards immediate changes in automatic thoughts and behavior early in therapy and then focusing on schema change later in therapy. 2. Some psychodynamic therapists have accused Jeff of re-inventing psychodynamic therapy (Jeff objects vigorously to this criticism). 3. Schema Therapy was developed in part as a way of understanding and treating personality disorders. I've argued in several places that one can unterstand and treat personality disorders within "standard" Cognitive Therapy without needing to introduce new theoretical concepts or develop a new variety of therapy. 4. Several works describing Schema Therapy contrast Schema Therapy with Cognitive Therapy for Depression and make no mention of the development of Cognitive Therapy approaches to understanding and treating personality disorders. This gives the misleading impression that Cognitive Therapists would approach the treatment of personality disorders just the same way as they approach the treatment of depression. It is hard to believe that one would criticize Cognitive Therapy's approach to treating personality disorders without even citing the published works on Cognitive Therapy with personality disorders but it has happened. 5. Cognitive Therapy has been tested in a large body of research which, by and large, supports the theory and shows that the therapy is effective. While there is research which supports some of Schema Therapy's concepts, I am not aware of any studies testing Schema Therapy's effectiveness and I am not aware of any evidence that it is more effective than Cognitive Therapy. Please note that I have my own biases on this subject. Jeff and I have disagreed on how to best conceptualize and treat personality disorders for nearly 20 years. I'd encourage contributions from others who have views for and against Schema Therapy.
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