Schema Therapy Identification — MRCPsych Paper B MCQ

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ModeratePsychotherapySchema Therapy IdentificationMRCPsych Paper B

A therapist formulates a patient's enduring patterns of emotional deprivation and abandonment as arising from unmet core emotional needs in childhood. Treatment uses a therapeutically bounded form of limited reparenting, imagery rescripting and chair dialogues to modify these patterns and strengthen a Healthy Adult mode. Which therapy is being described?

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Correct answer: B — Schema therapy

The answer is B, schema therapy. It conceptualises persistent patterns such as emotional deprivation and abandonment as early maladaptive schemas arising partly from unmet core emotional needs. Characteristic interventions include limited reparenting within professional boundaries, imagery rescripting, chairwork and work with schema modes such as the Vulnerable Child and Healthy Adult. Standard CBT may address core beliefs and can use imagery techniques, but this combination of concepts and methods is specifically characteristic of schema therapy. DBT primarily emphasises skills in mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. MBT focuses on improving mentalising, particularly under attachment-related stress. CAT uses reformulation, reciprocal roles and recognition or revision procedures rather than limited reparenting and schema-mode work.

Reference: Dadomo H, Panzeri M, Caponcello D, Carmelita A, Grecucci A. Schema therapy for emotional dysregulation in personality disorders: a review. Current Opinion in Psychiatry. 2018;31(1):43–49. https://www.nice.org.uk/guidance/cg78/resources/bpd-full-guideline-242147197