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

This study tested a 10-week multidisciplinary schema therapy inpatient treatment protocol for patients with personality disorders, including two individual and two group sessions per week, supportive sessions with nurse cotherapists, as well as art, music, sports group and individual body therapy. Twenty patients with specific or mixed PD participated. A concurrent multiple baseline design was used with randomly assigned baselines between 4 and 10 weeks. After baseline and admission, a 2-week attention control phase without interventions was followed by a 10-week treatment protocol and a 3-month follow-up without treatment. The primary outcomes were three dysfunctional negative idiosyncratic beliefs (NIB) as well as two positive beliefs regarding emotional-acceptance and self-acceptance (PB) assessed daily. The secondary outcomes were standard psychometric instruments assessed five times during the trial: a symptom checklist (SCL90R), a depression inventory (BDI2), a questionnaire to assess life satisfaction (FLZ), the number of PD-diagnoses (SCID2) as well as Young's Schema Questionnaire (YSQ3) and the Schema Mode Inventory (SMI). Data were analysed with mixed regression. The primary outcomes confirmed that treatment brought substantial improvements (NIB d = 1.36; PB d = 1.29) and that these improved further (NIB d = 1.63; PB d = 2.19) at follow-up. Similarly, the secondary outcomes showed that treatment led to substantial improvements both in negative (depression, symptom severity in general as well as PD symptoms, dysfunctional schemas and modes) and in positive (life satisfaction, functional modes) domains. This indicates that the ST programme did not only bring about a reduction of problems but also an increase in adaptive functioning and happiness.