Positive Constructs in Schema Therapy: A Scoping Review

Central to the schema therapy model is the development of early maladaptive schemas due to unmet emotional needs in childhood. Recently, focus has shifted towards positive constructs in schema therapy, including early adaptive schemas or positive schemas and positive schema modes, such as the "healthy adult" and "happy child." This scoping review explores theoretical perspectives, assessment, and therapeutic use of these positive constructs in schema therapy. The PRISMA-ScR methodology was followed, using predefined search terms and databases (OVID, EBSCO, Mednar). After identifying 345 studies, 144 remained post-deduplication. Articles were screened by two reviewers, and disagreements were settled by consensus among the research team. A total of 47 records were included. A growing interest in positive constructs within schema therapy was found since 2011. The healthy adult and the happy/contented child were the most frequently discussed constructs, followed by early adaptive schemas and positive coping. Key findings include a strong relationship between the healthy adult mode and psychological well-being, while negative correlations exist with psychopathology. Assessment focuses on questionnaires like the Schema Mode Inventory and Young Positive Schema Questionnaire, however empirical evidence for positive schema therapy interventions is lacking. Limitations include diverse publication types and preliminary findings. Recommendations for further research include clarifying the healthy adult mode construct, exploring positive coping, and integrating positive constructs into schema therapy for improved therapeutic outcomes.