Effects of a Six-Months Therapy Combining Schema Therapy with Exposure and Response Prevention for Patients with Chronic Anxiety and Comorbid Personality Disorders: an Explorative Study

Anxiety disorders and obsessive-compulsive disorders (OCD) are among the most common mental health issues worldwide (Ghaedi, Tavoli, Bakhtiari, Melyani, & Sahragard, 2010). Cognitive behavioral therapy (CBT) is the preferred treatment for patients with anxiety disorders or OCD. Even though CBT is effective for most patients, 30-40% of the patients do not respond to CBT (Durham, Chambers, MacDonald, Power, & Major, 2003). For those patients, often no alternative evidence-based psychological treatments are available. Therefore, new evidence-based therapies need to be developed. A new treatment program was developed for patients with an anxiety disorder or OCD and comorbid personality disorder: ‘SCHerp’ aims to reduce anxiety symptoms by combining and integrating schema therapy (SCH) with exposure and response prevention (erp). Previous observational research investigating the effectivity of SCHerp showed that 58.2% of the patients improved after treatment (Appel, Pranger, Stappenbelt, Burke, Van Passel, & Krans, submitted for publication). Although these results are promising, the SCHerp program can still be improved. The aim of this study is to evaluate, for each participant, the effectiveness of the SCHerp program in reducing both psychological malfunction and severity of disorder specific symptoms. In addition, we aim to evaluate changes in adaptive and maladaptive schema modes, and in implicit avoidance tendencies during the SCHerp program. Lastly, we aim to identify and generate hypotheses about periods within SCHerp with the highest gains (e.g. largest decline in anxiety/OCD symptoms) and provide insight into how changes in schema modes and disorder specific symptoms/psychological malfunction are associated in time.