BackgroundSchema therapy is effective for most outpatients with personality disorders (PDs). However, a subgroup does not sufficiently benefit from outpatient programmes. Despite its common clinical use, a thorough evaluation of day treatment group schema therapy (GST) is lacking.AimsThis study aimed to investigate the effectiveness of day treatment GST for patients with PDs.Methods and ProceduresNegative core beliefs were the primary outcome in a multiple baseline single‐case design, measured weekly before and during 30 weeks of day treatment GST. Secondary outcomes included severity of primary PD, early maladaptive schemas (EMS), schema modes and general psychopathology measured before and after day treatment GST. Intervention effects were evaluated through visual inspection and randomization test analysis, with a reliable change index calculated for the secondary outcome measures.Outcomes and ResultsA total of 79% of treatment completers showed a significant positive effect of day treatment GST with large effect sizes (Cohen's d: 0.96–10.04). Secondary outcomes supported these findings: 56% had a significant decrease in the severity of primary PD and 53% in general psychopathology. In addition, 63% of EMS and 72% of schema modes (87.5% for functional schema modes) showed significant positive reliable changes.Conclusions and ImplicationsThis is the first empirical study that demonstrated the effectiveness of day treatment GST in patients with severe PDs. Day treatment GST can serve as a stepped care treatment option for nonresponsive patients in outpatient programmes. Further randomized controlled (cost‐)effectiveness research is necessary to substantiate these findings and investigate the specific patient populations for which day treatment is essential.

中文翻译：

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日间治疗组图式疗法对人格障碍的有效性：多基线单病例研究

背景图式疗法对大多数患有人格障碍（PD）的门诊患者有效。然而，一个亚群体并没有充分受益于门诊项目。尽管其临床应用很常见，但仍缺乏对日间治疗组图式疗法 (GST) 的全面评估。目的本研究旨在调查日间治疗 GST 对 PD 患者的有效性。方法和程序负面核心信念是多基线的主要结果单病例设计，在日间治疗 GST 之前和期间每周测量一次。次要结局包括原发性 PD 的严重程度、早期适应不良图式 (EMS)、图式模式以及日间治疗 GST 之前和之后测量的一般精神病理学。通过目视检查和随机化测试分析来评估干预效果，并为次要结果测量计算可靠的变化指数。结果和结果总共 79% 的治疗完成者显示日间治疗 GST 具有显着的积极作用，且效应量较大（Cohen'sd：0.96–10.04）。次要结果支持了这些发现：56% 的原发性 PD 严重程度显着下降，53% 的一般精神病理学显着下降。此外，63% 的 EMS 和 72% 的图式模式（功能图式模式为 87.5%）显示出显着的积极可靠变化。结论和意义这是第一个证明日间治疗 GST 对严重 PD 患者有效性的实证研究。日间治疗 GST 可以作为门诊项目中无反应患者的阶梯式护理治疗选择。有必要进行进一步的随机对照（成本）有效性研究来证实这些发现并调查需要日间治疗的特定患者群体。