Evidence Base for Schema Therapy

Literature Review - Empirical evidence for Schema Therapy

 Borderline Personality Disorder

  1. Arntz, A. et al. (2022). Effectiveness of Predominantly Group Schema Therapy and Combined Individual and Group Schema Therapy for Borderline Personality Disorder A Randomized Clinical Trial. JAMA Psychiatry. Published online March 2, 2022. doi:10.1001/jamapsychiatry.2022.0010
  2. Arntz, A. Stupar-Rutemfrans, S., Bloo, J. & van Dyck. (2015) Prediction of treatment discontinuation and recovery from BPD: Results from an RCT comparing Schema Therapy and Transference Focused Psychotherapy. Behavior research and therapy, 74, 60-71.
  3. Farrell, J.M., Shaw, I.A., Webber, M.A. (2009) A schema-focused approach to group psychotherapy for outpatients with borderline personality disorder: a randomized controlled trial. Journal of Behavior Therapy and Experimental Psychiatry. 40, 317-328.
  4. Giesen-Bloo, J., van Dyck, R., Spinhoven, P., van Tilburg, W., Dirksen, C., van Asselt, T., Kremers, I., Nadort, M. & Arntz, A. (2006) Outpatient psychotherapy for borderline personality disorder: Randomised trial of schema-focused therapy versus transference-focused psychotherapy Archives of General Psychiatry, 63(6) 649-658.
  5. Nadort, M., Arntz, A., Smit, J.H., Giesen-Bloo, J., Eikelenboom, M., Spinhoven, P., van Asselt, T., Wensing, M. & van Dyck, R. (2009). Implementation of outpatient schema therapy for borderline personality disorder with versus without crisis support by the therapist outside office hours: A randomized trial. Behaviour Research and Therapy, 47(11), 961-973.
  6. Nadort, M., van Dyck, R., Smit, J.H., Giesen-Bloo, J., Eikelenboom, M., Wensing, M., Spinhoven, P., Dirksen, C., Bleecke, J., van Milligen, B. & van Vreeswijk, M. (2009). Three preparatory studies for promoting implementation of outpatient schema therapy for borderline personality disorder in general mental health care. Behaviour Research and Therapy, 47(11), 938-945.
  7. Sempertegui, G.A., Karreman, A., Arntz, A. & Bekker, M. (2012). Schema therapy for borderline personality disorder: a comprehensive review of its empirical foundations, effectiveness and implementation possibilities. Clinical Psychology Review, 33(3), 426-447.
  8. Tan YM, Lee CW, Averbeck LE, Brand-de Wilde O, Farrell J, Fassbinder E, et al. (2018) Schema therapy for borderline personality disorder: A qualitative study of patients’ perceptions. PLoS ONE 13(11): e0206039. https://doi.org/10.1371/journal.pone.0206039
  9. van Asselt, A. D. I., Dirksen, C. D., Arntz, A., Giesen-Bloo, J. H., van Dyck, R., Spinhoven, P., et al. (2008). Outpatient psychotherapy for borderline personality disorder: cost effectiveness of schema-focused therapy versus transference focused psychotherapy. Br. J. Psychiatry 192, 450–457. doi: 10.1192/bjp.bp.106.033597

Other Personality Disorders

  1. Bamelis, L., Evers, S., Spinhoven, P., & Arntz, A. (2014) Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders. The American Journal of Psychiatry, 17(3), 305-322.

Complex Trauma

1. Boterhoven de Haan, K.L., Lee, C.W., Fassbinder, E. et al. Imagery rescripting and eye movement desensitisation and  reprocessing for treatment of adults with childhood trauma-related post-traumatic stress disorder: IREM study design. BMC Psychiatry 17, 165 (2017). https://doi.org/10.1186/s12888-017-1330-2


  1. Carter, J., McIntosh, V., Jordan, J., Porter, R., Frampton, C. & Joyce, P. (2013). Psychotherapy for depression: a randomized clinical trial comparing schema therapy and cognitive behavior therapy. Journal of Affective Disorders, 151(2), 500-505. doi: 10.1016/j.jad.2013.06.034.
  2. Koruk, S., & Ozabaci, N. (2018). Effectiveness of Schema Therapy on the Treatment of Depressive Disorders: A Meta-Analysis/Sema Terapinin Depresif Bozukluklarin Tedavisindeki Etkililigi: Bir Meta-Analiz. Psikiyatride Guncel Yaklasimlar/Current Approaches to Psychiatry, 10(4), 460+. Retrieved from https://link.galegroup.com/apps/doc/A551167590/AONE?u=googlescholar&sid=AONE&xid=7b786d5e
  3. Malogiannis, I., Arntz, A., Spiropoulou, A., Aggeli, A., Karveli, S., Tsartsara, E., Vlavianou, M., Pehlivanidis, A., Papadimitriou, G. & Zervas, I. (2014). Schema Therapy for patients with chronic depression. A single case series study. Journal of Behavior Therapy and Experimental Psychiatry, 45, 319-329.
  4. Porter, R.J., Bourke, C., Carter, J.D., Douglas, K.M., McIntosh, V.V.W., Jordan, J., Joyce, P.R. and Frampton, C.M.A. (2016). No change in neuropsychological dysfunction or emotional processing during treatment of major depression with cognitive–behaviour therapy or schema therapy. Psychological medicine, 46(02), 393-404.
  5. Renner, F., Arntz, A., Leeuw, I., & Huibers, M. (2013). Treatment for chronic depression using schema therapy. Clinical Psychology: Science and Practice, 20(2), 166-180.
  6. Renner, F., Arntz, A., Peeters, F. P., Lobbestael, J., & Huibers, M. J. (2016). Schema therapy for chronic depression: Results of a multiple single case series. Journal of behavior therapy and experimental psychiatry, 51, 66-73.
  7. Seavey, A., & Moore, T. M. (2012). Schema-Focused Therapy for Major Depressive Disorder and Personality Disorder: A Case Study. Clinical Case Studies, 11(6), 457-473.

Anxiety Disorders

  1. Cockram, D., Drummond, P. & Lee, C. (2010). Role and treatment of early maladaptive schemas in Vietnam veterans with PTSD. Clinical Psychology and Psychotherapy, 17, 165-182.
  2. Gude, T. & Hoffart, H. (2008). Change in interpersonal problems after cognitive agoraphobia and schema focused therapy versus psychodynamic treatment as usual of inpatients with agoraphobia and Cluster C personality disorders. Scandinavian Journal of Psychology, 49, 195-199.

Eating Disorders

  1. McIntosh, V. V., Jordan, J., Carter, J. D., Frampton, C. M., McKenzie, J. M., Latner, J. D., & Joyce, P. R. (2016). Psychotherapy for transdiagnostic binge eating: A randomized controlled trial of cognitive-behavioural therapy, appetite-focused cognitive-behavioural therapy, and schema therapy. Psychiatry research, 240, 412-420.
  2. Brown, J., Selth, S., Stretton, A., Simpson, S. (2016). Do dysfunctional coping modes mediate the relationship between perceived parenting style and disordered eating behaviours? Journal of Eating Disorders 4(27):1-10. DOI: 10.1186/s40337-016-0123-1
  3. Edwards, D. J. A. (2017). An interpretative phenomenological analysis of schema modes in a single case of anorexia nervosa: Part 1 - Background, method and Child and Parent modes. Indo-Pacific Journal of Phenomenology, 17 (1), 1-13.  doi: 10.1080/20797222.2017.1326728.  
  4. Edwards, D. J. A. (2017). An interpretative phenomenological analysis of schema modes in a single case of anorexia nervosa: Part 2 - Coping modes, Healthy Adult mode, superordinate themes and implications for research and practice. Indo-Pacific Journal of Phenomenology, 17 (1), 1-12.  doi: 10.1080/20797222.2017.1326730
  5. Hodge, L. & Simpson, S. (2016). Speaking the Unspeakable: Artistic expression in Eating Disorder Research and Schema Therapy. The Arts in Psychotherapy. 50, 1-8. doi:10.1016/j.aip.2016.05.005
  6. Keith, L., Gillanders, D. & Simpson, S. (2009). An exploration of the main sources of shame in an eating disordered population. Clinical Psychology & Psychotherapy, 16, 317-327.
  7. Simpson, S. (2012). Schema Therapy for Eating Disorders: a case study illustration of the Mode Approach. In van Vreeswijk, M., Broersen, J. & Nadort, M. (Eds.) The Wiley-Blackwell Handbook of Schema Therapy: Theory, Research and Practice. Oxford, UK: Wiley-Blackwell. Pp145-171.
  8. Simpson, S., Morrow, E., van Vreeswijk, M. & Reid, C., (2010). Group schema therapy for eating disorders: A pilot study. Frontiers in Psychology in Clinical Settings, 1, 182.
  9. Simpson, S. & Slowey, L. (2011). Video Therapy for Atypical Eating Disorder and Obesity: A Case Study. Clinical Practice and Epidemiology in Mental Health, 7(1), 38-43. doi:10.2174/1745017901107010038
  10. Talbot, D., Smith, E., Tomkins, A., Brockman, R., Simpson, S. Schema modes in eating disorders compared to a community sample. Journal of Eating Disorders. 3(1), 1. doi:10.1186/s40337-015-0082-y

Forensic Applications

  1. Bernstein, D., Keulen-de Vos, M., Clercx, M., De Vogel, V., Kersten, G., Lancel, M., . . . Arntz, A. (2021). Schema therapy for violent PD offenders: A randomized clinical trial. Psychological Medicine, 1-15. doi:10.1017/S0033291721001161
  2. Bernstein, D., Arntz, A. & de Vos, M. (2007) Schema Focused Therapy in Forensic Settings: Theoretical Model and Recommendations for Best Clinical Practice. International Journal of Forensic Mental Health, 6(2), 169-183.
  3. Bernstein, D.P., Nijman, H., Karos, K., Keulen-de Vos, M., de Vogel, V., & Lucker, T. (2012). Schema Therapy for forensic patients with personality disorders: Design and preliminary findings of multicenter randomized clinical trial in the Netherlands. International Journal of Forensic Mental Health, 11, 312-324.
  4. Chakhssi, F., Kersten, T., de Ruiter, C., & Bernstein, D.P. (2014). Treating the untreatable: A single case study of a psychopathic patient treated with Schema Therapy. Psychotherapy. Psychotherapy (Chic), 51(3):447-61. doi: 10.1037/a0035773

Schema Therapy for other complex psychological difficulties & comorbidities

  1. Arjan C. Videler, Rita J. J. Van Royen, Sylvia M. J. Heijnen-Kohl, Gina Rossi, Sebastiaan P. J. Van Alphen, and Christina M. Van der Feltz-Cornelis (2017). Adapting Schema Therapy for Personality Disorders in Older Adults. International Journal of Cognitive Therapy: 10 (1): 62-78. https://doi.org/10.1521/ijct.2017.10.1.62
  2. Gojani, P.J., Masjedi, M. Khaleghipour, S. & Behzadi, E. (2017) Effects of Schema Therapy and Mindfulness on the Maladaptive Schemas Hold by the Psoriasis Patients with the Psychopathology Symptoms. Adv Biomed Res. 6: 4.
  3. Khatamsaz, B., Forouzandeh, E., Ghaderi, D. (2017). Effectiveness of schema therapy on marital satisfaction and marital relationship quality in married women. Int J Educ Psychol Res; 3:11-16
  4. Tapia, G. Perez-Dandieu, B., Lenoir, H. Delile, J. (2017). Treating addiction with schema therapy and EMDR in women with co-occurring SUD and PTSD: A pilot study. Journal of Substance Use. Doi: 10.1080/14659891.2017.1378743
  5. Vuijka, R. & Arntz, A. (2017) Schema therapy as treatment for adults with autism spectrum disorder and comorbid personality disorder: Protocol of a multiple-baseline case series study testing cognitive-behavioral and experiential interventions, Contemproary Clinical Trials Communications, 5, 80 -85. https://doi.org/10.1016/j.conctc.2017.01.001

Group Schema Therapy

  1. Dickhaut, V. & Arntz, A. (2014). Combined group and individual schema therapy for borderline personality disorder: A pilot study. J. Behav. Ther. & Exp. Psychiat. 45, 242e251
  2. Farrell, J., Shaw, I., Webber, M. (2009). A schema-focused approach to group psychotherapy for outpatients with borderline personality disorder: a randomized controlled trial. J Behav Ther Exp Psychiatry, 40(2), 317-28. doi: 10.1016/j.jbtep.2009.01.002. Epub 2009 Jan 14.
  3. Skewes, S., Samson, R., Simpson, S. & van Vreeswijk, M. (2014). Short-term group schema therapy for mixed personality disorders: A pilot study Frontiers in Psychology, 5, 1592. doi:10.3389/fpsyg.2014.01592
  4. Simpson, S., Skewes, S., van Vreeswijk, M. & Samson, R. (2015). Commentary: Short-term group schema therapy for mixed personality disorders: An introduction to the treatment protocol. Frontiers in Psychology, 6 (Article 609), 1-3. doi:10.3389/fpsyg.2015.00609
  5. van Vreeswijk M. F., Spinhoven P., Eurelings-Bontekoe E. H. M., Broersen J. (2012). Changes in symptom severity, schemas and modes in heterogeneous psychiatric patient groups following short term schema cognitive-behavioural group therapy: a naturalistic pre-post treatment design in an outpatient clinic. Clin. Psychol. Psychother. 21, 29–38 doi:10.1002/cpp.1813

General Review Articles

  1. Bakos, D.S., Gallo, A.E. & Wainer, R. (2015). Systematic review of the clinical effectiveness of schema therapy. Contemp Behav Health Care, 1.  doi: 10.15761/CBHC.1000104
  2. Hopwood, C. & Thomas, K. (2014). Schema therapy is an effective treatment for avoidant, dependent and obsessive-compulsive personality disorders. Evid Based Ment Health;17(3):90-1. doi: 10.1136/eb-2014-101858.
  3. Jacob, G., Arntz, A. (2013). Schema Therapy for Personality Disorders – A Review. International Journal of Cognitive Therapy, 6(2), 171-185.
  4. Masley, S., Gillanders, D., Simpson, S. & Taylor, M. (2012). A Systematic Review of the Evidence Base for Schema Therapy. Cognitive behaviour therapy, 41(3), 185-202. doi:10.1080/16506073.2011.614274
  5. Pugh, M. (2015). A narrative review of schemas and schema therapy outcomes in the eating disorders. Clinical Psychology Review, 39, 30-41.
  6. Sempertegui, G.A., Karreman, A., Arntz, A. & Bekker, M. (2012). Schema therapy for borderline personality disorder: a comprehensive review of its empirical foundations, effectiveness and implementation possibilities. Clinical Psychology Review, 33(3), 426-447.
  7. Taylor, C. D. J., Bee, P. and Haddock, G. (2016), Does schema therapy change schemas and symptoms? A systematic review across mental health disorders. Psychol Psychother Theory Res Pract. doi:10.1111/papt.12112

Techniques and methods in Schema Therapy

  1. Arntz, A. (2011). Imagery rescripting for personality disorders. Cognitive and Behavioral Practice, 18, 466–481. doi:10.1016/j.cbpra.2011.04.006Pugh, M. (2017) Pull Up a Chair. The Psychologist. 30, 42-47.
  2. Arntz, A. (2016) Imagery Rescripting for Personality Disorders: Healing Early Maladaptive Schemas, in Working with Emotion in Cognitive-Behavioral Therapy Techniques for Clinical Practice, McKay, D. & Thoma, N. (Eds), Guildford, New York.
  3. Brockman, R. N., & Calvert, F. L. (2016). Imagery Rescripting for PTSD and Personality Disorders: Theory and Application. Journal of Contemporary Psychotherapy, 1-8.
  4. Ten Napel-Schut, M, Abma, T., Bamelis, L. & Arntz, A. (2011). Personality disorder patients’ perspectives on the introduction of imagery within schema therapy: a qualitative study of patients’ experiences. Cognitive and Behavioral Practice, 18, 482–490. doi:10.1016/j.cbpra.2011.04.005
  5. Weertman, A. & Arntz, A., (2007). Effectiveness of treatment of childhood memories in cognitive therapy for personality disorders: a controlled study contrasting methods focusing on the present and methods focusing on childhood memories. Behavior Research and Therapy, 45, 2133-2143.

Training DVDs for Clinicians

  1. Van der Wijngaart, R & Hayes, C. (2016). Fine Tuning Imagery Rescripting, (3 disk DVD), www.schematherapytraining.com
  2. Hayes, C. & van der Wijngaart, R. (2018). Fine Tuning Chair Work in Schema Therapy (3 disk DVD), www.schematherapytraining.com
  3. van der Wijngaart, R. & van Genderen, H. (2018). Schema Therapy: Step by Step.www.schematherapy.nl/Step-by-Step/

Self-Help Books for Clients

  1. Behary, W. (2013).  Disarming the narcissist: Surviving and thriving with the self-absorbed. New Harbinger.
  2. Jacob, G., van Genderen, H. & Seebauer, L. (2015) Breaking negative thinking patterns: A schema therapy self-help and support book. Chichester: Wiley-Blackwell.
  3. Louis, J. & Louis, K. (2015). Good Enough Parenting: An in-depth perspective on meeting core emotional needs and avoiding exasperation. NY: Morgan James.
  4. Stevens, B. & Roediger, E. (2016). Breaking negative relationship patterns: a schema therapy self-help and support book. Chichester: Wiley-Blackwell.
  5. Stevens, B. (2017). Hidden Learning: The Way we are wired for intimacy. Fremantle: Vivid Publishing.
  6. Young, J. E., & Klosko, J. S. (1994). Reinventing your life. The breakthrough program to end negative behavior ... and feel great again. New York: Plume.

Dec 2018 - Lisa Chantler and Susan Simpson