Psychotherapists’s Perception of Schema Therapy Education in Brazil and the Difficulties They Face in Clinical Practice

Authors

DOI:

https://doi.org/10.1590/0103-6564e240046

Keywords:

clinical education, psychotherapists, schema therapy

Abstract

Schema therapy constitutes a psychotherapeutic approach that has been gaining popularity in Brazil. This study aims to investigate psychotherapists’ perceptions of it and the difficulties they face in clinical practice. This qualitative and exploratory study included online interviews. We have conducted semi-structured interviews with 18 Brazilian psychotherapists (M = 35.05; SD = 5.24) that lasted from 30 minutes to one hour. We recruited psychotherapists by a snowball approach for the convenience sample of this study in 2020. Furthermore, we conducted a reflexive thematic analysis on NVIVO 12. Psychotherapists reported difficulties managing their own schemas, transferring theoretical knowledge to clinical practice, and managing challenging patients. The strategies the psychotherapists cited the most included supervision, personal therapy, management of the agenda, and theoretical studies. We suggest that the Brazilian schema therapy formal education program should incorporate supervision into its program.

Downloads

Download data is not yet available.

Author Biographies

  • Daniely Fernandes Kamazaki, Universidade Federal do Rio Grande do Sul

    Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.

  • Ana Cristina Garcia Dias, Universidade Federal do Rio Grande do Sul

    Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.

  • Maria Eduarda Pedroso, Universidade Federal do Rio Grande do Sul

    Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.

References

Bach, B., & Bernstein, D. P. (2019). Schema therapy conceptualization of personality functioning and traits in ICD-11 and DSM-5. Current Opinion in Psychiatry, 32(1), 38-49. doi: 10.1097/YCO.0000000000000464

Barletta, J. B., Fonseca, A. L. B. da, & Delabrida, Z. N. C. (2012). A importância da supervisão de estágio clínico para o desenvolvimento de competências em terapia cognitivo-comportamental. Psicologia: Teoria e Prática, 14(3), 153-167. Recuperado de https://www.redalyc.org/pdf/1938/193824911013.pdf

Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589-597. doi: 10.1080/2159676X.2019.1628806

Conselho Federal de Psicologia – CFP. (2022). Quem faz a psicologia brasileira? Um olhar sobre o presente para construir o futuro: Formação e inserção no mundo do trabalho, volume I – formação e inserção no mundo do trabalho. Brasília, DF: CFP. Recuperado de https://site.cfp.org.br/wp-content/uploads/2022/12/Censo_psicologia_Vol1_WEB.pdf

Coren, S., & Farber, B. A. (2019). A qualitative investigation of the nature of “informal supervision” among therapists in training. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 29(5), 679-690. doi: 10.1080/10503307.2017.1408974

Easden, M. H., & Kazantzis, N. (2018). Case conceptualization research in cognitive behavior therapy: A state of the science review. Journal of Clinical Psychology, 74(3), 356-384. doi: 10.1002/jclp.22516

Frank, H. E., Becker‐Haimes, E. M., & Kendall, P. C. (2020). Therapist training in evidence‐based interventions for mental health: A systematic review of training approaches and outcomes. Clinical Psychology: Science and Practice, 27(3), e12330. doi: 10.1111/cpsp.12330

Hayes, J. A., Gelso, C. J., Goldberg, S., & Kivlighan, D. M. (2018). Countertransference management and effective psychotherapy: Meta-analytic findings. Psychotherapy, 55(4), 496. doi: 10.1037/pst0000189

Josek, A. K., Schaich, A., Braakmann, D., Assmann, N., Jauch-Chara, K., Arntz, A., … Fassbinder, E. (2023). Chairwork in schema therapy for patients with borderline personality disorder—A qualitative study of patients’ perceptions. Frontiers in Psychiatry, 14, e1180839. doi: 10.3389/fpsyt.2023.1180839

Klein, R. H., Bernard, H. S., & Schermer, V. L. (Eds.). (2010). On becoming a psychotherapist: The personal and professional journey. New York: Oxford University Press.

Koppeschaar, A., Bachrach, N., & Arntz, A. (2023). Timing of imagery rescripting during schema therapy for borderline personality disorder: the LUCY trial. Frontiers in Psychiatry, 14, e1204439. doi: 10.3389/fpsyt.2023.1204439

McMain, S. F., Boritz, T. Z., & Leybman, M. J. (2015). Common strategies for cultivating a positive therapy relationship in the treatment of borderline personality disorder. Journal of Psychotherapy Integration, 25(1), 20. doi: 10.1037/a0038768

Moe, F. D., & Thimm, J. (2021). Personal therapy and the personal therapist. Nordic Psychology, 73(1), 3-28. doi: 10.1080/19012276.2020.1762713

Pilkington, P. D., Spicer, L., & Wilson, M. (2022) Schema therapists’ perceptions of the influence of their early maladaptive schemas on therapy. Psychotherapy Research, 32(7), 833-846. doi: 10.1080/10503307.2022.2038804

Putrino, N., Casari, L., Mesurado, B., & Etchevers, M. (2020). Psychotherapists’ emotional and physiological reactions toward patients with either borderline personality disorder or depression. Psychotherapy Research, 30(7), 912-919. doi: 10.1080/10503307.2019.1690176

Roscoe, J., & Taylor, J. (2023). Maladaptive therapist schemas in CBT practice, training and supervision: A scoping review. Clinical Psychology & Psychotherapy, 30(3), 510-527. doi: 10.1002/cpp.2802

Schaffler, Y., Probst, T., Pieh, C., Haid, B., & Humer, E. (2024). Prevalence of mental health symptoms and potential risk factors among Austrian psychotherapists. Scientific Reports, 14(1), e3888. doi: 10.1038/s41598-024-54372-7

Simpson, S., Simionato, G., Smout, M., Vreeswijk, M. F. van, Hayes, C., Sougleris, C., & Reid, C. (2019). Burnout amongst clinical and counseling psychologists: The role of early maladaptive schemas and coping modes as vulnerability factors. Clinical Psychology & Psychotherapy, 26(1), 35-46. doi: 10.1002/cpp.2328

Sperry, L., & Carlson, J. (2013). How master therapists work: Effecting change from the first through the last session and beyond. New York: Routledge.

Sudak, D. M., III, R. T. C., Ludgate, J. W., Sokol, L., Fox, M. G., Reiser, R. P., & Milne, D. L. (2015). Teaching and supervising cognitive behavioral therapy. Hoboken: Wiley.

Vinuto, J. (2014). A amostragem em bola de neve na pesquisa qualitativa: Um debate em aberto. Temáticas, 22(44), 203-220. doi: 10.20396/tematicas.v22i44.10977

Vreeswijk, M. V., Broersen, J., & Nadort, M. (Eds.). (2012). The Wiley-Blackwell handbook of schema therapy: Theory, research, and practice. Chichester: Wiley.

Yang, Y., & Hayes, J. A. (2020). Causes and consequences of burnout among mental health professionals: A practice-oriented review of recent empirical literature. Psychotherapy, 57(3), 426-436. doi: 10.1037/pst0000317

Young, J. E., Klosko, J. S., Weishaar, M. E., Knapp, P., & Costa, R. C. (2008). Terapia do esquema: Guia de técnicas cognitivo-comportamentais inovadoras. Porto Alegre, RS: Artmed.

Zhang, K., Hu, X., Ma, L., Xie, Q., Wang, Z., Fan, C., & Li, X. (2023). The efficacy of schema therapy for personality disorders: A systematic review and meta-analysis. Nordic Journal of Psychiatry, 77(7), 641-650. doi: 10.1080/08039488.2023.2228304

Published

2025-07-25

Issue

Section

Articles

How to Cite

Psychotherapists’s Perception of Schema Therapy Education in Brazil and the Difficulties They Face in Clinical Practice. (2025). Psicologia USP, 36, e240046. https://doi.org/10.1590/0103-6564e240046