Cognitive Behavioral Model Of Low Self-Esteem (Fennell, 1997)

Low self-esteem is characterized as a negative sense of the self and co-occurs with many other mental health problems. Although not formally represented in the diagnostic manuals it is nevertheless a distinct and treatable psychological difficulty. Negative self-evaluation is common, and low self-esteem can feature as a consequence of other primary conditions such as obsessive compulsive disorder (OCD) or post-traumatic stress disorder (PTSD).  In these cases, negative self-beliefs are often addressed during the treatment of the primary difficulty. However, when negative self-beliefs feature as a primary difficulty, or as a vulnerability factor for other conditions such as in depression or social anxiety, then addressing the underlying low self-esteem is considered an important target for treatment.

Melanie Fennell’s Cognitive Behavioral Model of Low Self-Esteem (1997) is an adaptation of Aaron T. Beck’s (1976) generic model of emotional disorders. The model suggests that life experiences shape an individual’s beliefs

“It would be helpful to explore and understand how your low self-esteem developed and what is keeping it going. I wonder if we could explore some of your thoughts, feelings, and reactions to see what kind of pattern they follow?”

1. Early experiences: Help the client to explore important events from their childhood, and emotional memories and relationships with their caregivers (e.g. were they loving, critical, neglectful). Reflect on early life experiences, prompting for any adverse or difficult experiences. Consider using both open and closed questions:
   • The environment we grow up in, the way others treat us, and the experiences we go through have a big impact on our self-esteem. Let’s explore the experiences you have had in life that have affected your self-esteem.
   • What was growing up like for you? (prompt for family life, school life, friendships, relationships etc.). Did you go through any difficult times growing up?

• Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: International University Press.
• Fennell, M. J. (1997). Low self-esteem: A cognitive perspective. Behavioural and Cognitive Psychotherapy, 25(1), 1-26.
• Padesky, C. A. (1990). Schema as self-prejudice. International Cognitive Therapy Newsletter, 6(1), 6-7.