Schema therapy with cognitive behaviour day-treatment in patients with treatment-resistant anxiety disorders and obsessive-compulsive disorder: An uncontrolled pilot study

Title

Schema therapy with cognitive behaviour day-treatment in patients with treatment-resistant anxiety disorders and obsessive-compulsive disorder: An uncontrolled pilot study

Reference

Remmerswaal, K. C., Cnossen, T. E., van Balkom, A. J., & Batelaan, N. M. (2023). Schema therapy with cognitive behaviour day-treatment in patients with treatment-resistant anxiety disorders and obsessive-compulsive disorder: an uncontrolled pilot study. Behavioural and Cognitive Psychotherapy, 1-6.

Abstract

Background:
Treatment resistance in patients with anxiety disorders and obsessive-compulsive disorder (OCD) might be caused by dysfunctional personality traits or, more specifically, early maladaptive schemas (EMSs) and schema modes, that can be treated with schema therapy (ST).

Aim:
To explore possible effectiveness of ST-CBT day-treatment in patients with treatment-resistant anxiety disorders and OCD in an uncontrolled pilot study.

Method:
Treatment-resistant patients with anxiety disorders or OCD (n = 27) were treated with ST-CBT day-treatment for 37 weeks on average including 11.5 therapy hours per week. The Symptom Questionnaire-48, Young Schema Questionnaire-2 and Schema Mode Inventory were completed before and after treatment.

Results:
General psychopathology, EMSs and schema modes significantly improved after treatment. Spearman’s correlations between pre- to post-treatment difference scores of general psychopathology, EMSs and schema modes were significant and high. The level of pre-treatment EMSs and schema modes did not predict post-treatment general psychopathology.

Conclusions:
Symptom reduction was strongly correlated with improvement of EMSs and schema modes. Stronger pre-treatment EMSs and schema modes did not hinder improvement of symptoms. ST-CBT day-treatment is promising for patients with treatment-resistant anxiety disorders and OCD. Further controlled research is needed to substantiate evidence for schema therapy in patients with treatment-resistant anxiety disorders and OCD.

Keywords

anxiety disorders; day-treatment; obsessive-compulsive disorder; schema-focused therapy; schema therapy; treatment-resistant; Behavior Therapy; Obsessive Compulsive Disorder; Treatment; Personality Traits; Psychopathology; Schema; Cognitive Therapy; Pilot

Country

Netherlands

Sample type

Clinical

Study focus

Schema therapy effectiveness

Study design

Non randomised trial