“Core beliefs” are the implicit views that people hold about themselves, others, the world, life itself, and the future. Formed on the basis of personal experience, modeling from important others (e.g., primary caregivers), and social influence at large, core beliefs shape the way we process information and affect our perceived quality of life. In therapy, many of our patients demonstrate problematic core beliefs that are manifested as negative biases against themselves, serious doubts about the utility of trying to change (helplessness), and bleak, limited views of their future (hopelessness). The “deepest” and most impactful of the core beliefs are known as “early maladaptive schemas” or simply “schemas” for short. For example, patients who manifest schemas such as mistrust, vulnerability to harm, unrelenting standards, defectiveness (and others, particularly if they are maintained to a severe degree), will not change their views spontaneously or easily, and will pose challenges, including in the therapeutic relationship. CBT is most effective and has the most staying power when therapists help their patients learn to moderate and modify their dysfunctional core beliefs and schemas, and to live their lives in concordance with the positively changed beliefs.

Modifying core beliefs and schemas requires a collaborative therapeutic relationship, a well-formulated, data-driven case conceptualization, the repeated use of a range of cognitive, behavioural, emotional (and also interpersonal) interventions, and a healthy dose of patience and persistence from both therapist and patient. This workshop will summarize the ways that therapists hypothesize and further assess their patients’ core beliefs and schemas, such as via open-ended questioning, and the use of well-established inventories. Additionally, we will highlight the place that core beliefs and schemas occupy in case conceptualization. This workshop will include clear descriptions of how therapists provide their patients with psychoeducation about core beliefs and schemas, thus setting the stage for therapeutic collaboration in identifying the core beliefs and schemas that are targets for intervention. Clinical vignettes will be presented to illustrate the process of respectfully validating the patients’ core beliefs and schemas to a limited extent in light of their developmental history and other background variables (including cultural factors). These same vignettes will further describe the ways that therapists help patients to give consideration to a wider range of ways of thinking – in other words, to be more flexible in their thinking, more open to new information that serves as evidence against core beliefs and schemas, and more motivated to pursue therapeutic goals that will support a more diverse and functional set of beliefs about themselves, their lives, and their future. Interventions will range from standard methods of verbal and written rational responding, to experiential methods such as role-playing and guided imagery, to behavioural experiments as part of homework, to focusing on the therapeutic relationship for improved interpersonal beliefs and schemas.

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