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Originalia

Schematherapie

Published Online:February 17, 2015https://doi.org/10.1026/1616-3443/a000278

Abstract

Schematherapie ist ein integrativer psychotherapeutischer Ansatz insbesondere zur Behandlung von Persönlichkeitsstörungen (PS) und Patienten mit chronischen und komplexen psychischen Störungen. Er kombiniert Konzepte der Verhaltenstherapie, der Tiefenpsychologie sowie humanistischer Ansätze, insb. der Gestalttherapie. Ein Schwerpunkt der Arbeit liegt auf emotionsfokussierten Techniken. Neben einem allgemeinen störungsübergreifenden Konzept wurden störungsspezifische Modelle für verschiedene PS entwickelt. Mehrere randomisiert-kontrollierte Studien wurden bisher bei Patienten mit Borderline-PS durchgeführt. Eine große randomisiert-kontrollierte Studie wurde zudem bei Patienten mit verschiedenen anderen PS abgeschlossen, eine weitere große Studie läuft bei forensischen Patienten. Alle bisherigen Studien zeigen eine gute Wirksamkeit, wobei eine ausreichende Dauer der Behandlung ausschlaggebend zu sein scheint. Forschung zu den schematherapeutischen Konstrukten weist auf eine gute Validität hin, allerdings auch auf eine hohe Überlappung mit anderen Maßen für Psychopathologie. Die aktuell zu beobachtende Ausweitung auf eine Vielzahl von Achse I-Störungen wird kritisch diskutiert.


Schema Therapy

Schema therapy is an integrative psychotherapy approach mainly for patients with personality disorders (PD) and other chronic mental disorders. It combines a cognitive-behavioral approach with psychodynamic and humanistic (mainly gestalt therapy) concepts. It emphasizes the use of experiential treatment techniques. It comprises both a general and a disorder-specific approach for different PDs. Several randomized-controlled trials (RCT) have been conducted in patients with borderline PD. One large RCT also investigated patients with other PD. A further RCT in forensic patients is under way. All studies so far show very good results. In borderline personality disorder (BPD), better results are related to longer treatment duration. Studies investigating the basic constructs show good validity but also substantial overlap with other measures of psychopathology. The current trend to apply schema therapy to all types of mental disorders including axis I disorders is discussed.

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