For some people, the issue isn’t a single problem but a pattern that keeps repeating: the same kind of relationship that always seems to break down, the same nagging sense of not being good enough, the same need for control, or the same instinct to avoid difficult situations altogether. When shorter, symptom-focused treatments don’t bring enough lasting change, schema therapy can offer a different way forward. At Mavera GGZ in Rotterdam, we offer schema therapy to clients whose deep-rooted patterns continue to shape their daily life and relationships.
What exactly is a schema?
In schema therapy, a “schema” refers to a fixed pattern of thinking, feeling and behaving that usually develops in childhood or adolescence. It often forms when core needs, such as safety, acceptance, autonomy or healthy boundaries, were not sufficiently met growing up.
A child who grows up surrounded by constant criticism, for example, may develop a schema along the lines of “I am not good enough.” In adulthood, this schema tends to resurface in situations that, on the surface, have little to do with childhood: at work, in a relationship, or among friends. People often respond through a fixed “mode”, such as overcompensating, avoiding the situation entirely, or reacting with anger and distance.
It is worth emphasising that a schema is not a fixed character trait and not a life sentence. It is a learned pattern, and learned patterns can be reshaped with the right guidance.
Who is schema therapy for?
Schema therapy tends to be most useful when difficulties have been present for a long time and keep recurring despite earlier treatment. It can be appropriate for:
- Personality-related difficulties, including patterns consistent with a preliminary DSM-5 classification of borderline personality traits
- Recurring relationship problems, such as repeatedly ending up in the same kind of conflict or breakdown with partners
- Chronic mood difficulties connected to deeply held beliefs about oneself or others
- Persistent patterns of avoidance, perfectionism or dependency
At Mavera GGZ, any diagnosis is always formulated carefully and cautiously, as a preliminary DSM-5 classification. This serves as a guiding framework for treatment, never as a definitive label.
How does schema therapy work?
Schema therapy is an integrative form of treatment, drawing on several established approaches:
- Cognitive behavioural therapy (CGT), to identify and challenge unhelpful thinking patterns
- Psychodynamic therapy, to understand where a pattern originated in someone’s personal history
- Experiential techniques, such as chair work and imagery exercises, to make emotional contact with the underlying needs behind a pattern
In practice, you and your therapist explore which schemas and modes are active for you, where they come from, and how they currently influence your behaviour and relationships. The work happens step by step: learning to recognise a pattern as it arises, and gradually building a more flexible, healthier way of responding.
A longer-term process, coordinated by a lead clinician
Because schemas are deeply rooted and often present for many years, schema therapy is usually a longer-term process than, say, a symptom-focused course of CGT. Real change takes time, repetition and practice in everyday life.
At Mavera GGZ, every treatment trajectory is coordinated by a regiebehandelaar, a BIG-registered lead clinician who oversees the overall treatment plan. This clinician works with you to set treatment goals and reviews progress at least once every three months, so the approach stays aligned with what you need, even over a longer course of treatment.
What to expect at Mavera GGZ
Every trajectory starts with a thorough intake, where we map out together which patterns are at play and what realistic treatment goals look like. Mavera GGZ works with BIG-registered psychologists and a psychiatrist, and offers care in several languages, including Dutch, Turkish, English, Ukrainian, Polish, Uyghur and Arabic. Specialist mental healthcare in the Netherlands requires a referral from your GP (huisarts).
The average waiting time for an intake is around three weeks, with treatment typically starting within about three months. Mavera GGZ is contracted with health insurers DSW and RMA/RMO, and has a payment agreement with Zilveren Kruis and VGZ. Keep in mind the mandatory deductible (eigen risico), which is €385 in 2026.
When to seek urgent help
Schema therapy is designed for lasting change over time and is not intended for acute crisis situations. If you are in crisis, or worried about your own safety or someone else’s, please call 112 (in the Netherlands) or go to A&E.
If you recognise yourself in patterns that have followed you for years and you are wondering whether schema therapy might help, speak to your GP about a referral, or call Mavera GGZ on 010 – 254 38 96 for more information.
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