Schema Mode Screening Questionnaire
A 70-item self-reflection assessment covering 14 schema modes, with automatic scoring, detailed interpretation, mode-pattern analysis and a visual pie chart.
Participant information
These fields are optional and remain only on this device unless the page is printed.
Instructions
Think about your experience during the past four weeks. Choose the response that best describes how frequently each statement applied to you. Answer honestly rather than selecting how you think you should respond.
Questionnaire
Select one answer for every statement.
Schema Mode Profile
This profile shows relative mode activation during the past four weeks. It should be explored in context, not treated as a fixed label or diagnosis.
Relative mode activation
The chart uses each mode’s average score to show its share of the full profile.
Chart legend
Average score for each mode, from 1.00 to 6.00.
Overall interpretation
Complete score profile
| Rank | Schema mode | Average | Activation level | Clinical meaning for exploration |
|---|
Detailed interpretation of every mode
Possible mode combinations
Suggested counselling focus
Clinical safety reminder
Questionnaire scores must never replace a direct safety assessment. Seek immediate professional or emergency support when there are current thoughts, plans or intent to harm oneself or another person; severe loss of control; psychotic symptoms; severe dissociation; abuse; immediate danger; or inability to meet basic needs.
High responses to anger, attack or self-punishment items require careful follow-up questions, but the score alone does not establish present danger.