title: Effects of schema group therapy in older outpatients: a proof of concept study.
abstract: BACKGROUND
  Short-term group schema cognitive behavior therapy (SCBT-g) showed improvements in overall symptomatology, early maladaptive schemas (EMS) and schema modes, both in adults and adolescents with personality disorder (PD) features and long-standing mood disorders. However, no research has yet been carried out on the effect in older adults. Therefore, in a proof of concept study, we explored the effect of SCBT-g in older outpatients with PD features and longstanding mood disorders.
  
  
  METHODS
  Thirty-one older outpatients, aged 60-78 years with PD features and/or longstanding mood disorders were included in a proof of concept study with pre-mid-post design. Primary outcome was psychological distress (Brief Symptom Inventory) and intermediate outcomes were EMS (Young Schema Questionnaire) and schema modes (Schema Mode Inventory), assessed at baseline, mid-treatment and end-of-treatment. Paired samples t-tests were conducted, and Cohen's d effect sizes reported for pre mid- and post-treatment. As proof of concept analysis, hierarchical regression analyses with residual change scores were used to analyse whether early process changes in EMS (intermediate outcomes) predicted later outcome changes in symptoms.
  
  
  RESULTS
  SCBT-g led to significant improvement in all three measures of psychological symptoms, EMS and modes with medium effect sizes. Pre-treatment to mid-treatment changes in schema severity predicted symptom improvement from mid- to end-of-treatment.
  
  
  CONCLUSIONS
  This proof of concept study shows that SCBT-g has potential to change EMS and to show significant effect at symptom level in older outpatients with PD features. A control condition in a randomized controlled trial is a necessary step for further research.
authors.affiliation: Breburg Hospital, Department of Old Age Psychiatry, Tilburg, the Netherlands.|Department of Clinical & Life Span Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium.|Tilburg University, Tranzo Department, Tilburg, the Netherlands.
authors.forename: A C
authors.initials: AC
authors.lastname: Videler
authors.affiliation: Department of Clinical & Life Span Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Rossi
authors.affiliation: Psychology Practice Schoevaars, Capelle aan den IJssel, the Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Schoevaars
authors.affiliation: Tilburg University, Tranzo Department, Tilburg, the Netherlands.|Clinical Centre for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands.|Trimbos Institute, Board, Utrecht, the Netherlands.
authors.forename: C M
authors.initials: CM
authors.lastname: van der Feltz-Cornelis
authors.affiliation: Department of Clinical & Life Span Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium.|Mondriaan Hospital, Department of Old Age Psychiatry, Heerlen-Maastricht, the Netherlands.
authors.forename: S P J
authors.initials: SPJ
authors.lastname: van Alphen
mesh_terms: D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000628:therapy*; D010554:Personality Disorders / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods*; D016896:Treatment Outcome