Schema Model – Here And Now

Formulation in talking therapies

Formulations (also known as case formulations, case conceptualizations, and working hypotheses) are a central component of most talking therapies and a key skill for mental health professionals (Division of Clinical Psychology [DCP], 2010; Royal College of Psychiatrists [RCP], 2017; Sperry & Sperry, 2012). In essence, a formulation is a way to make sense of an individual’s difficulties. It is a provisional account or hypothesis, informed by psychological theory, about what an individual is struggling with and why (Johnstone & Dallos, 2014). A formulation is also a tool that therapists use to relate theory to practice (Butler, 1998). Sperry and Sperry (2012) describe formulations as:

A method and clinical strategy for obtaining and organizing information about a client, understanding and explaining the client’s situation and maladaptive patterns, guiding and focusing treatment, anticipating challenges and roadblocks, and preparing for successful termination.

Formulation is a fundamental part of most (if not all)

"Schemas are an understandable response to our early experiences. They help us make sense of what happened to us when we were young. But as our lives change, these old patterns might not be accurate or fit our current reality, which can make them unhelpful. I’d like to explore one of your schemas in more detail. We can do that by creating a diagram together. Would that be OK?"

Step 1: Select an EMS to explore

Ask the client to choose an EMS that they would like to explore in depth. Since clients’ primary or core EMS are usually the starting point for schema-focused treatment, these schemas are ideal to begin with. According to Young (1999), primary EMS can be identified using three criteria:

1. They trigger the strongest emotional reactions.
2. They relate to the client’s most pervasive life difficulties
3. They are linked to their most significant developmental challenges.

You might ask:

• "Which schema would you like to

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• Arntz, A., & Van Genderen, H. (2021). Schema therapy for borderline personality disorder (2nd ed.). John Wiley and Sons.
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• Brockman, R. N., Simpson, S., Hayes, C., van der Wijngaart, & Smout, M. (2023). Cambridge guide to schema therapy. Cambridge University Press.
• Burns, D. D. (1980). Feel