Schema therapists' perceptions of the influence of their early maladaptive schemas on therapy

Objective: This qualitative survey aimed to explore schema therapists' perceptions of how their early maladaptive schemas are activated in their therapeutic work, and how they manage their reactions. Method: An online qualitative survey was conducted with 22 schema therapists. Following brief demographic questions, participants were asked three open-ended questions about their schema activation and associated reactions. An inductive-deductive hybrid thematic analysis of the qualitative responses identified four superordinate themes and 12 subthemes. Results: Participants described several negative impacts on their therapeutic work, including avoiding limit setting, becoming argumentative or aggressive, detaching or avoiding, and over-functioning. An array of strategies for managing schema and countertransference reactions were identified, including refocusing on the client's vulnerability, caring for one's own vulnerability and connecting with one's healthy adult self, and engaging in supervision, training, personal therapy, and self-care. Notably, several participants described how their internal reactions can be used advantageously to conceptualize and support clients, and to facilitate therapists' personal development. Conclusion: The findings highlighted that although schema and associated countertransference experiences can be challenging, awareness and effective management of therapists' reactions can benefit treatment and promote personal growth.