Vulnerability To Harm

The Vulnerability To Harm resource is designed to help clients and therapists to work more effectively with common early maladaptive schemas (EMS).

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Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

Overview

Schema therapy posits that many psychological and relational difficulties stem from early maladaptive schemas (EMS) and associated coping styles. EMS are deeply ingrained patterns in how people think and feel, influencing they perceive and respond to themselves, other people, and the world. The vulnerability to harm schema where is characterized by persistent fears about catastrophic events and an perceived inability to cope with them. This handout is part of the Psychology Tools Schema series, designed to help therapists and clients address common EMS.

Why Use This Resource?

This resource helps mental health professionals understand the Vulnerability to Harm schema, enabling more effective recognition, treatment planning, and interventions for clients experiencing pervasive anxiety and fear.

  • Provides a theoretical framework for understanding early maladaptive schemas.
  • Describes the experience and origins of the Vulnerability to Harm schema.
  • Offers suggestions for how to address this schema.

Key Benefits

Understanding

Outlines the origins and maintenance of the vulnerability to harm schema.

Practical

Details some of the ways this schema can be healed in therapy.

Accessible

Includes relatable examples of how people experience vulnerability to harm.

Who is this for?

Health Anxiety

Excessive concerns about health-related issues.

Panic Disorder

Catastrophic misinterpretations of physical sensations.

Other Difficulties

Vulnerability to harm has been associated with OCD, chronic pain, and many other issues.

Integrating it into your practice

01

Educate

Begin with psychoeducation about schemas and coping styles.

02

Identify

Help clients explore whether they have a Vulnerability to Harm schema.

03

Monitor

Recognize where, when, and why this schema is activated.

04

Heal

Address Vulnerability to Harm using key interventions, such as cognitive restructuring, exposure, and limited reparenting.

Theoretical Background & Therapist Guidance

Schema therapy integrates multiple approaches into a unifying framework. It is based on the idea that many difficulties stem from EMS - enduring structures composed of thoughts, emotions, memories, and physical sensations. Schema therapy expands on traditional CBT by focusing on the development origins of clients' difficulties and incorporating experiential and relational techniques to address EMS.

Clients with a vulnerability to harm schema fear that something disastrous could happen at any moment. These fears might relate to their health, finances, specific situations, or objects (e.g., phobias). Others worry they might lose control or go mad. Being in this constant state of high alert is often highly stressful and exhausting.

What's inside

  • Comprehensive guide to understanding early maladaptive schemas and associated coping styles.
  • A resource for understanding and recognizing the Vulnerability to Harm schema.
  • Insights the origins of this EMS and other schemas that are sometimes associated with it.
Get access to this resource

FAQs

A vulnerability to harm schema involves a pervasive fear of impending disaster and a belief in one's inability to cope with it. It often results in chronic anxiety and avoidance behaviors.
Schema therapy incorporates relational and experiential methods to address the deep-rooted beliefs formed early in life and perpetuated through maladaptive coping mechanisms.
Focus on challenging catastrophic thinking, reducing safety behaviors, facing feared situations, and helping clients care for the 'frightened child' inside themselves.

How This Resource Improves Clinical Outcomes

By exploring the Vulnerability to Harm schema, this resource can be used to:

  • Increase awareness and recognition of this schema.
  • Help engage clients in therapy.
  • Inform schema case conceptualizations.
  • Guide treatment planning.

Therapists benefit from:

  • A clear overview of schema theory and the Vulnerability to Harm schema.
  • Enhanced understanding of clients' maladaptive belief systems.
  • A easy-to-understand resource that clients can relate to.

References And Further Reading

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  • Moulding, R., & Kyrios, M. (2006). Anxiety disorders and control related beliefs: The exemplar of obsessive-compulsive disorder (OCD). Clinical Psychology Review, 26, 573–583. https://doi.org/10.1016/j.cpr.2006.01.009
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  • Loose, C., Graaf, P., Zarbock, G., & Holt, R. A. (2020). Schema therapy for children and adolescents (ST-CA): A practitioner’s guide. Pavilion.
  • Lorian, C. N., & Grisham, J. R. (2011). Clinical implications of risk aversion: An online study of risk-avoidance and treatment utilization in pathological anxiety. Journal of Anxiety Disorders, 25, 840–848. https://doi.org/10.1016/j.janxdis.2011.04.008
  • Lorzangeneh, S., & Esazadegan, A. (2022). The role of early maladaptive schema domains and childhood trauma in predicting cognitive distortions. Journal of Research in Psychopathology, 3, 1–8. https://doi.org/10.22098/JRP.2022.10098.1049
  • Louis, J. P., Wood, A. M., Lockwood, G., Ho, M.-H. R., & Ferguson, E. (2018). Positive clinical psychology and Schema Therapy (ST): The development of the Young Positive Schema Questionnaire (YPSQ) to complement the Young Schema Questionnaire 3 Short Form (YSQ-S3). Psychological Assessment, 30, 1199–1213. https://doi.org/10.1037/pas0000567
  • Lumley, M. N., & Harkness, K. L. (2007). Specificity in the relations among childhood adversity, early maladaptive schemas, and symptom profiles in adolescent depression. Cognitive Therapy and Research, 31, 639–657. https://doi.org/10.1007/s10608-006-9100-3
  • Maniglio, R. (2013). Child sexual abuse in the etiology of anxiety disorders: A systematic review of reviews. Trauma, Violence, and Abuse, 14, 96–112. https://doi.org/10.1177/1524838012470032
  • May, T., Younan, R., & Pilkington, P. D. (2022). Adolescent maladaptive schemas and childhood abuse and neglect: A systematic review and meta‐analysis. Clinical Psychology and Psychotherapy, 29, 1159–1171. https://doi.org/10.1002/cpp.2712
  • Meier, S. M., & Deckert, J. (2019). Genetics of anxiety disorders. Current Psychiatry Reports, 21, 1–8. https://doi.org/10.1007/s11920-019-1002-7
  • Mizara, A., Papadopoulos, L., & McBride, S. R. (2012). Core beliefs and psychological distress in patients with psoriasis and atopic eczema attending secondary care: The role of schemas in chronic skin disease. British Journal of Dermatology, 166, 986–993. https://doi.org/10.1111/j.1365-2133.2011.10799.x
  • Moore, P. S., Whaley, S. E., & Sigman, M. (2004). Interactions between mothers and children: Impacts of maternal and child anxiety. Journal of Abnormal Psychology, 113, 471–476. https://doi.org/10.1037/0021-843X.113.3.471
  • Moulding, R., & Kyrios, M. (2006). Anxiety disorders and control related beliefs: The exemplar of obsessive-compulsive disorder (OCD). Clinical Psychology Review, 26, 573–583. https://doi.org/10.1016/j.cpr.2006.01.009
  • Murray, L., Creswell, C., & Cooper, P. J. (2009). The development of anxiety disorders in childhood: An integrative review. Psychological Medicine, 39, 1413–1423. https://doi.org/10.1017/S0033291709005157
  • Nia, M. K., & Sovani, A. (2014). Cross cultural comparison role of early maladaptive schemas and coping styles between women with depressive symptoms in Iran and India. Journal of Applied Environmental and Biological Sciences, 4, 57–65.
  • Nicol, A., Mak, A. S., Murray, K., Walker, I., & Buckmaster, D. (2020). The relationships between early maladaptive schemas and youth mental health: A systematic review. Cognitive Therapy and Research, 44, 715–751. https://doi.org/10.1007/s10608-020-10092-6
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