[Show abstract][Hide abstract] ABSTRACT: Background: Schema Therapy (ST), a psychotherapy model integrating cognitive, experiential and behavioural interventions, was initially developed and evaluated as an outpatient treatment for patients with severe and chronic disorders, among them Borderline Personality Disorder (BPD). Two randomized controlled trials have demonstrated the effectiveness of ST for BPD, delivered in an individual or group format, in the outpatient setting. However, the most severely impaired BPD patients are referred to inpatient treatment due to suicidality and severe self-harm. Specialized inpatient treatment programs are limited, with little evaluative research. Aims: The pilot studies are designed to be first steps in naturalistic clinical settings to evaluate the effects of an intensive inpatient ST treatment program. Method: This report presents the results of three independent uncontrolled pilot studies with a total of 92 BPD patients. The programs combine individual and group modalities and are consistent theoretically with the ST model for BPD patients. Results: Results show that inpatient ST can significantly reduce symptoms of severe BPD and global severity of psychopathology with effect sizes ranging from Cohen's d = 2.84 to Cohen's d = .43. Conclusions: Differences in the effect sizes across the three pilot studies could be explained by length of treatment, number of group psychotherapists and their training. Although there are limitations to the presented pilot studies such as differences in the samples, treatment settings, variations in the treatment itself and the use of different measures, which may have influenced outcome, they are a starting point for describing and evaluating inpatient treatment for BPD in naturalistic settings.
Behavioural and Cognitive Psychotherapy 03/2013; · 1.69 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study tests the effectiveness of adding an eight-month, thirty-session schema-focused therapy (SFT) group to treatment-as-usual (TAU) individual psychotherapy for borderline personality disorder (BPD). Patients (N=32) were randomly assigned to SFT-TAU and TAU alone. Dropout was 0% SFT, 25% TAU. Significant reductions in BPD symptoms and global severity of psychiatric symptoms, and improved global functioning with large treatment effect sizes were found in the SFT-TAU group. At the end of treatment, 94% of SFT-TAU compared to 16% of TAU no longer met BPD diagnosis criteria (p<.001). This study supports group SFT as an effective treatment for BPD that leads to recovery and improved overall functioning.
Journal of Behavior Therapy and Experimental Psychiatry 02/2009; 40(2):317-28. · 2.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This paper describes a new approach to increasing emotional stability in patients with borderline personality disorder (BPD) through experiential exercises designed to increase their level of emotional awareness. This approach, called Emotional Awareness Training, is hypothesized to provide the groundwork for emotional stability in BPD patients and to be an important prerequisite to the effective use of cognitive and behavioral interventions with these patients. A comprehensive model for the treatment of BPD is described, which begins with emotional awareness training, followed by training in distress reduction and emotional regulation skills, and work on identifying and challenging early maladaptive cognitive schemas. A treatment manual for Emotional Awareness Training is available from the authors. The models for BPD treatment of Dialectical Behavior Therapy and Cognitive Therapy are reviewed and the issue of research to evaluate the effectiveness of cognitive-behavioral treatment is discussed.
Cognitive and Behavioral Practice 06/1994; 1(1):71-91. · 1.33 Impact Factor