An Exploration of Schema Modes in Psychosis

Schema focused therapy (SFT; Young et al., 2003), which includes schema mode work, was developed for people with a borderline personality disorder diagnosis, and more recently has expanded for use with other diagnoses. A research gap exists in relation to schema modes and psychosis. This study
aims to explore the relevance of schema modes to people with a psychosis diagnosis.

Seven adults with a psychosis diagnosis took part in a semi-structured interview and completed the Schema Mode Inventory (SMI; Young et al., 2007) questionnaire. In the interview participants were presented with eight cards, each with a description of one of Young et al.’s (2003) original schema
modes. Participants were asked a series of questions about each mode card. Following the interview, participants completed the SMI. Interviews were transcribed verbatim and interview data were organised into eight matrices, one matrix per schema mode. Data were analysed per matrix using
thematic analysis. SMI scores were calculated and compared with interview transcripts.

A sense of separateness from others and feelings of shame, anger and difficulty regulating overwhelming emotion appeared common across the sample. Stigma was highlighted as a possible influencing factor. Whilst many descriptions of emotional and behavioural states given by participants may reflect some of Young’s (2003) existing schema modes, and SMI data highlighted three modes of possible relevance to people with a psychosis diagnosis, findings were inconclusive.
The findings suggested that if modes are found to be relevant to this population, experiences of voice-hearing and paranoia could influence the experience of a mode. Some discrepancies found between SMI and interview data highlighted the importance of using more than one method when
assessing modes.

A critical review discussed the findings and highlighted limitations. Implications of the findings were considered in relation to clinical practice and at a wider service and
societal level. Recommendations were made for future research.