Schema Mode Inventory

8/16/2019 Schema Mode Inventory

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This is a very valuable inventory developed by Jeff Young, the developer or Schema Therapy, and some of his colleagues.

To start the questionnaire, click on the

"Questionnaire" tab at the bottom of your screen

and that the answers are in the grey boxes.

hen you have completed the questionnaire, click on the

"Scoring Sheet" tab at the bottom of the sheet.

To print the Scoring Sheet, specify that you only want to print

pages 1 to 7 (see white arrows).

S!#$% $&'# ()*#)T&+Y *ersion -.-

#o!plete the personal details$ /)ame/, /'ate of 0irth/, /ighest level of #ducation/ co!pleted, and /Today/s 'ate/.

%ead the (nstructions.

%ead each &uestion and place your answer (1, ', , , *, or +) in the grey bo1 on the right side. a"e sure you ans2er all the questions

Sae the docu!ent to -S$( *-.- Surname, First Name"

or exa!ple, S$( *-.- 0logs, John"

#mail your docu!ent to !e at graale13iafrica com


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#mail your docu!ent to !e at graale13iafrica com

S!#$% $&'# Q4#ST(&))%(+# *ersion -.-

)ame5

'ate of 0irth5

ighest #ducation5

Today/s 'ate5

(nstruction /isted below are state!ents that people !ight use to describe the!seles. 0lease rate each

6+#Q4#)!Y5 (n general . . .

- 7 )ever or %lmost )ever 8 7 6requently

9 7 +arely : 7 $ost of the time

; 7 &ccasionally < 7 %ll of the time

(n general . . . Score

1. de!and respect by not letting other people push !e around.

'. feel loed and accepted.

. deny !yself pleasure because don2t desere it.

. feel funda!entally inade&uate, flawed, or defectie.

*.

+. feel lost.

7. 2! hard on !yself.

3. try ery hard to please other people in order to aoid conflict, confrontation, or re4ection.

5. can2t forgie !yself.

16. do things to !a"e !yself the centre of attention.

11. get irritated when people don2t do what as" the! to do.

ite! based on ho2 often you beliee or feel each state!ent in general using the fre&uency table.

hae i!pulses to punish !yself by hurting !yself (e.g., cutting !yself).


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S$( *ersion -.- 6+#Q4#)!Y5 (n general . . .





1. f can2t reach a goal, beco!e easily frustrated and gie up.

1. hae rage outbursts.

1*. act i!pulsiely or express e!otions that get !e into trouble or hurt other people.

1+. t2s !y fault when so!ething bad happens.

17. feel content and at ease.

13. change !yself depending on the people 2! with, so they2ll li"e !e or approe of !e.

15. feel connected to other people.

'6. hen there are proble!s, try hard to sole the! !yself.

'1. don2t discipline !yself to co!plete routine or boring tas"s.

''. f don2t fight, will be abused or ignored.

'. hae to ta"e care of the people around !e.

'. f you let other people !oc" or bully you, you2re a loser.

'*. physically attac" people when 2! angry with the!.

'+. 8nce start to feel angry, often don2t control it and lose !y te!per.

'7.

'3. feel indifferent about !ost things.

'5. can sole proble!s rationally without lettintg !y e!otions oerwhel! !e.

6. t2s ridiculous to plan how you2ll handle situations.

1. won2t settle for second best.

'. Attac"ing is the best defence.

feel cold and heartless towards other people

t2s i!portant for !e to be 9u!ber 8ne (e.g., the !ost popular, !ost successful, !ost wealthy, !ost powerful, etc.)


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.






*. blindly follow !y e!otions.

+. feel desperate.

7. allow other people to critici:e !e or put !e down.

3. n relationships, let the other person hae the upper hand.

5. feel distant fro! other people.

6. don2t thin" about what say, and it gets !e into trouble or hurts other people.

1. wor" or play sports intensiely so that don2t hae to thin" about upsetting things.

'. 2! angry that people are trying to ta"e away !y freedo! or independence.

. feel nothing.

. do what want to do, regardless of other people2s needs and feelings.

*. don2t let !yself relax or hae fun until 2e finished eerything 2! supposed to do.

+. throw things around when 2! angry.

7. feel enraged towards other people.

3. feel that fit in with other people.

5. hae a lot of anger built up inside of !e that need to let out.

*6. feel lonely.

*1. try to do !y best at eerything.

*'.

*. &uality doesn2t exist, so it2s better to be superior to other people.

* hen 2! angry often lose control and threaten other people

feel detached (no contact with !yself, !y e!otions, or other people).

li"e doing so!ething exciting or soothing to aoid !y feelings (e.g., wor"ing ga!bling, eating, shopping, sexual actiities, watching T


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**. let other people get their own way instead of expressing !y own needs.

*+. f so!eone is not with !e, he or she is against !e.






*7. n order to be bothered less by !y annoying thoughts or feelings, !a"e sure that 2! always busy.

*3. 2! a bad person if get angry at other people.

*5. don2t want to get inoled with people.

+6. hae been so angry that hae hurt so!eone or "illed so!eone.

+1. feel that hae plenty of stability and security in !y life.

+'. "now when to express !y e!otions and when not to.

+. 2! angry with so!eone for leaing !e alone or abandoning !e.

+. don2t feel connected to other people.

+*. can2t bring !yself to do things that find unpleasant, een if "now it2s for !y own good.

++. brea" rules and regret it later.

+7. feel hu!iliated.

+3. trust !ost other people.

+5. act first and thin" later.

76. get bored easily and lose interest in things.

71. en if there are people around !e, feel lonely.

7'. don2t allow !yself to do pleasurable things that other people do because a! bad.

7. assert what need without going oerboard.

7. feel special and better that !ost other people.


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7+. t !a"es !e angry when so!eone tells !e how should feel or behae.

77. f you don2t do!inate other people, they will do!inate you.

73. say what feel, or do things i!pusiely, without thin"ing of the conse&uences.



9 7 +arely : 7 $ost of the time; 7 &ccasionally < 7 %ll of the time


75. feel li"e telling people off for the way they hae treated !e.

36. 2! capable of ta"ing care of !yself.

31. 2! &uite critical of other people.

3'. 2! under constant pressure to achiee and get things done.

3. 2! trying not to !a"e !ista"es; otherwise, 2ll get down on !yself.

3. desere to be punished.

3*. can learn, grow, and change.

3+. want to distract !yself fro! upsetting thoughts and feelings.

37. 2! angry at !yself.

33. feel f lat.

35. hae to be the best in whateer do.

56. sacrifice pleasure, health, or happiness to !eet !y own standards.

51. 2! de!anding of other people.

5'. f a! angry, can get so out of control that in4ure other people.

5. a! inulnerable.

5. 2! a bad person.

5* feel safe


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5+. feel listened to, understood, and alidated.

57. t is i!possible for !e to control !y i!pulses.

53. destroy things when 2! angry.

55. =y do!inating other people, nothing can happen to you.






166. act in a passie way, een when don2t li"e the way things are.

161. y anger gets out of control.

16'. !oc" or bully other people.

16. feel li"e lashing out of hurting so!eone for what he>she did to !e.

16. "now that there is a 2right2 and a 2wrong2 way to do things; try hard to do things th right way, or else start critici:ing !yself.

16*. often feel alone in the world.

16+. feel wea" and helpless.

167. 2! la:y.

163. can put up with anything fro! people who are i!portant to !e.

165. 2e been cheated or treated unfairly.

116. f feel the urge to do so!ething, 4ust do it.

111. feel left out of excluded.

11'. belittle others.

11. feel opti!istic.

11. feel shouldn2t hae to follow the sa!e rules that other people do.

11* y life right now reoles around getting things done and doing the! 2right2


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11+. 2! pushing !yself to be !ore responsible than !ost people are.

117. can stand up for !yself when feel unfairly citici:ed, abused, or ta"en adantage of.

113. don?t desere sy!pathy when so!ething bad happens to !e.

115. feel that nobody loes !e.

1'6. feel that 2! basically a good person.






1'1. hen necessary, co!plete boring and routine tas"s in order to acco!plish things alue.

1''. feel spontaneous and playful.

1'. can beco!e so angry that feel capable of "lling so!eone.

1'. hae a good sense of who a! and what need to !a"e !yself happy.

#)' &6 Q4#ST(&))%(+#

)o2 go to the Scoring Sheet 2orksheet


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S!#$% $&'# ()*#)T&+Y *#+S(&) -.- S!&+()= S##T)ame5 Sample Sam 'ate5 -8>?@>9?-9

Item Response Mode Code 5? 6? 5 or 6

1 6 =A 6 6 6

' 6 ## 6 6 6

6 00 6 6 6

6


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* 6 # 6 6 6

+ 6


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7' 6 00 6 6 6

7 6 A 6 6 6

7 6 SA 6 6 6

7* 6 B0 6 6 6

7+ 6 A# 6 6 6

77 6 =A 6 6 6

73 6 # 6 6 6

75 6 A# 6 6 6

36 6 A 6 6 6

31 6 SA 6 6 6

3' 6 DPa 6 6 6

3 6 DPa 6 6 6

3 6 00 6 6 6

3* 6 A 6 6 6

3+ 6 BS 6 6 6

37 6 00 6 6 6

33 6 B0 6 6 6

35 6 SA 6 6 6

56 6 DPa 6 6 6

51 6 SA 6 6 6

5' 6 # 6 6 6

5 6 =A 6 6 6

5 6 00 6 6 65* 6 ## 6 6 6

5+ 6 ## 6 6 6

57 6 # 6 6 6

53 6 # 6 6 6

55 6 =A 6 6 6

166 6 #S 6 6 6

161 6 # 6 6 6

16' 6 =A 6 6 6

16 6 A# 6 6 6


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165 6 A# 6 6 6

116 6 # 6 6 6

111 6


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Total Scores of each odeSa!ple Sa! Bate$ 1>67>'61'

Vulnerable Child (10)

Angry Child (10)

Enraged Child (10)

Impulsive Child (9)

Undisciplined Child (6)

Conened Child! (10)

Complian "urrenderer (#)

$eached %roecor (9)

$eached "el&'"ooher ()

"el&'Aggrandier (10)

*ully + Aac, (9)

%uniive %aren (10)

$emanding %aren (10)

-ealhy Adul! (10)

0.0 1.0 /.0 .0 .0 .0 6.0


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A Bo2 scores significant e num er n rac e s n ca es e num er o ques ons n eac o e

9u!ber of *2s and +2s on each odeSa!ple Sa! Bate$ 1>67>'61'

Vulnerable Child (10)

Angry Child (10)

Enraged Child (10)

Impulsive Child (9)

Undisciplined Child (6)

Conened Child! (10)

Complian "urrenderer (#)

$eached %roecor (9)

$eached "el&'"ooher ()

"el&'Aggrandier (10)

*ully + Aac, (9)

%uniive %aren (10)

$emanding %aren (10)

-ealh Adul! 10

0 1 / 6 # 2 9 10


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A Bo2 scores significant

The number in brackets indicates the number of questions in each $ode

9or!s for S


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Documents

Schema Mode Inventory