Schema Therapy for Depression
by Arnoud Arntz, Alexandra Schosser, Eckhard Roediger, Martin Rein, Silke Bramer-Ugur, and Marit Kool
Schema Therapy for Depression - Treating Symptoms and Healing Schemas?
This symposium is aimed at evaluating the use of schema therapy in recurrent, chronic and comorbid depression from a scientific perspective. Originally formulated as a transdiagnostic approach for patients with personality disorders, Schema Therapy is constantly extending its clinical use towards the treatment of Axis-I disorders and we want to present a rationale why ST might work for depressive disorders. The speakers will present recent data from four large clinical trials in order to accumulate empirical evidence for the effectiveness of schema therapy in the treatment of depression on a symptom and schema level. Clinical and research implications will be discussed based on the presented data. We will also point out how schema therapy can be integrated into inpatient settings and adapted to shorter time frames.
Talk 1: Martin Rein will give a short introduction into the empiric foundations of the schema theoretic rationale and presents results of the OPTIMA study - a randomized controlled trial comparing schema therapy and cognitive behavior therapy for depressed patients in an inpatient setting.
Talk 3: To evaluate the effect of short timed schema interventions Eckhard Roediger presents data from 448 patients treated in a 4- week inpatient schema based program of a Psychosomatic Clinic under naturalistic conditions.
Talk 4: Marit Kool will present preliminary data on the psychotherapy dosage (PSYDOS-) trial- a randomized controlled trial comparing two dosages (25 vs 50 sessions) of psychotherapy for patients with co-occurring depression and personality disorders. Schema Therapy and Short-term Psychodynamic Supportive Psychotherapy are presented as promising options to effectively treat depression that is interwoven with long-standing personality patterns.
Talk 5: Silke Bramer-Ugur will share her one-year experience from a pilot-project in an inpatient unit where schema therapy is applied to patients suffering from mood disorders and severe neurosis complicated by personality traits. The talk provides suggestions how schema therapy can be effectively integrated in an inpatient setting in regard to the clinical practices in Germany.
schema Therapy for Patients with Major Depression - Results from a Randomized Controlled Trial Comparing Schema Therapy and Cognitive Behavior Therapy in an Inpatient Setting (OPTIMA trial)
General Abstract for Presentation 1:
Schema Therapy for Patients with Major Depression - Results from a Randomized Controlled Trial Comparing Schema Therapy and
Cognitive Behavior Therapy in an Inpatient Setting (OPTIMA trial)
Martin Rein, Nils Kappelmann, Samy Egli, Katharina Rek, Julia Fietz, Johannes Kopf-Beck Max-Planck-Institut for Psychiatry, Munich, Germany
Schema Therapy versus Cognitive Behavioural Psychotherapy in a 6-weeks and 20-weeks ambulant rehabilitation programme
General Abstract for Presentation 2:
Schema Therapy versus Cognitive Behavioural Psychotherapy in a 6-weeks and 20-weeks ambulant rehabilitation programme 1,2Alexandra Schosser, 1Daniela Fischer-Hansal, 1Gabriele Riedl, 1Nicole Pritz, 1Susanne Dür, 1Christoph Teufl, 1Anna Hülsmann, 1Andreas Affenzeller, 1Birgit Senft
Results from a 4-week inpatient schema based program of a Psychosomatic Clinic under naturalistic conditions.Presenter's Name:
Eckhard RoedigerGeneral Abstract for Presentation 3:
Schema therapy has primarily been developed in out-patient treatment setting and gained first evidence base there, while research on in-patient treatment setting is still hard to find. The clinical study presented here indicates strong effects in a 4-week inpatient schema based program of a Psychosomatic Clinic under naturalistic conditions. Especially depression symptoms of the 448 patients in the PHQ decreased with an effect size of d = 1.0.
Applying schema therapy in specialized inpatient and day clinic units – treatment concept of LVR Klinikum Düsseldorf, hospital of Heinrich-Heine-University
Silke Bramer-UgurGeneral Abstract for Presentation 4:
A proportion of psychiatric inpatients with mood disorders does not improve satisfyingly during and after usual hospital treatment, which is defined by the national guidelines in Germany (Guidance Manual and Rules for Guideline Development) and treatment settings defined by staffing ratios based on the Psychiatry Personal Act (Psychiatrie Personalverordnung). However psychiatric inpatient units hardly match the recommended number of physicians and the treatment mostly amounts to a combined pharmacological, unspecified and cogntive-behavioral treatment. There is an increasing body evidence indicating that Schematherapy ist one of the most efficatious treatments of dysfunctional cognitions and interpersonal interactions. These conditions mostly complicate the course of mood disorders. In a pilot project the Department of Psychiatry of the University Clinics of Dusseldorf has established an inpatients unit were Schematherapy is applied to patients suffering from mood disorders, and severe neurosis complicated by personality traits. One year of clinical experience now suggests a higher rate of complete remissions and less relapses. The approach seems superior to standard treatment which is in accordance with guidelines. Further research based on randomized and controlled trials is needed to prove its efficacy and determine the staffing ratios in the wake of imminent changes in the Psychiatry Personal Act.
About the Presenters:
Arnoud Arntz is professor of Clinical Psychology at the University of Amsterdam, the Netherlands, with an affiliation at Maastricht University, the Netherlands. His main research interests lie in the fields of PTSD and personality disorders, both applied and fundamental. He also practices as a psychotherapist at PsyQ in Amsterdam, where he treats patients with trauma and personality disorders. Together with Adam Radomsky he was editor of the Journal of Behavior Therapy and Experimental Psychiatry.
Martin Rein (MD), born 1977, psychiatrist and psychotherapist. Supervisor in cognitive behavioural therapy and advanced schema therapist, supervisor and trainer. Father of 2 children and currently living in munich. After medical training at the universities of Hamburg and Heidelberg, clinical fellow in neurology at the university clinics in Heidelberg. Consecutively clinical training in psychiatry and psychotherapy at the Max-Planck-Institute of Psychiatry in Munich. Consultant psychiatrist and head of the outpatient clinic and the psychotherapy ward for the last 3 years. As a member of the IST-M in Munich workshops and lectures with a focus on schema therapy for depression. In addition to the clinical work, research activity with a major focus on psychotherapeutic treatment of affective disorders.
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