Schema therapy is particularly notable for its dual focus. It seeks to change cognitive and behavioral patterns and fulfill unmet emotional needs through the therapeutic relationship itself. Therapists work to create a nurturing environment, often stepping into roles that provide the validation, care, or challenge missing from a patient's life. This approach helps clients heal and modify their schemas, encouraging more adaptive coping strategies.

The therapy incorporates techniques like imagery rescripting and chairwork, where clients engage in dialogues with different parts of themselves or reimagine past traumatic experiences in a less distressing way. This is intended to weaken the influence of negative schemas and bolster the client's capacity to respond to challenges in healthier ways.