Inpatient Schema Therapy: Results of a Multiple Baseline Case Series Study

Area of Science:

• Psychiatry and Psychology
• Clinical Psychology
• Psychotherapy Research

Background:

• Personality disorders (PD) present complex challenges requiring intensive treatment.
• Schema Therapy (ST) is a transdiagnostic approach targeting deeply ingrained maladaptive schemas.
• Inpatient treatment offers a controlled environment for intensive therapeutic interventions.

Purpose of the Study:

• To evaluate the efficacy of a 10-week multidisciplinary inpatient schema therapy protocol for patients with personality disorders.
• To assess the impact of the ST program on both negative and positive belief systems.
• To examine changes in psychological symptoms, life satisfaction, and schema-related constructs.

Main Methods:

• A 10-week inpatient schema therapy protocol involving individual/group sessions, supportive nursing care, and adjunctive therapies (art, music, sports, body therapy).
• Twenty patients with specific or mixed PD participated.
• A concurrent multiple baseline design with a 2-week attention control phase, followed by treatment and a 3-month follow-up.

Main Results:

• Significant improvements were observed in primary outcomes: reduction in dysfunctional negative idiosyncratic beliefs (NIB) and increase in positive beliefs (PB) regarding emotional and self-acceptance.
• Effect sizes for NIB and PB were substantial during treatment and further increased at follow-up (NIB d=1.63; PB d=2.19).
• Secondary outcomes showed significant reductions in depression, general symptom severity, PD symptoms, and dysfunctional schemas/modes, alongside increases in life satisfaction and functional modes.

Conclusions:

• The multidisciplinary inpatient schema therapy program is effective in treating personality disorders.
• The treatment not only reduces psychological problems but also enhances adaptive functioning and subjective well-being.
• Sustained improvements suggest the long-term benefits of intensive schema therapy for PD patients.