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• Numorous psychotherapeutic approaches have been put forward to better treat patients with chronic psychological problems or severe personality disorders, among them Schema Therapy (Young, Klosko & Weishaar, 2003). Within Schema Therapy, there are two important theoretical constructs: early maladaptive schemas, which are conceptualized as stable and lasting emotional, behavioral and cognitive patterns regarding ourselves, the world and other people that have their origins in childhood or adolescence and schema modes, which are current states that describe the rapid shifts in emotion, cognition and behaviour that can be seen in patients with severe personality disorders. Schema Therapy has growing popularity with clinicians in the last decade, but only a few studies have tested the empirical validity of the schema mode model. Lobbestael, van Vreeswijk, Spinhoven, Schouten & Arntz (2010) developed and evaluated the Schema Mode Inventory to assess schema modes within the framework of a questionnaire. This instrument has been translated to the German language and the psychometric properties of the instrument indicate an adequate fit to the model established in the original Dutch study (paper 1). In Schema Therapy, on the one hand mode concepts have been proposed without a focus on one specific disorder (Young et al., 2003), but on the other hand disorder-specific concepts have been established that form the basis for manualization and research. The most popular disorder specific mode concept is that of Borderline Personality Disorder (Arntz & van Genderen, 2009). In randomized controlled trials the effectiveness of Schema Therapy for Borderline Personality Disorder in the individual setting (Giesen-Bloo, van Dyck, Spinhoven, van Tilburg, Dirksen et al., 2006) and the group setting (Farrell, Shaw & Webber, 2009) was evaluated. Whereas Schema Therapy for Borderline Personality Disorder in the individual setting has been manualized (Arntz & van Genderen, 2009), a manual for group Schema Therapy is not yet available, Therefore, particularly since this last evaluation study, there has been a need to better describe, how the Schema Therapy mode model for Borderline Personality Disorder has been applied to the group setting (papers 2 & 3) as well as how both modalities of Schema Therapy treatment, individual and group, are combined in intensive psychotherapy settings such as inpatient or day care (papers 4 & 5). Lastly the question has been put forward as to how effective Schema Therapy for Borderline Personality Disorder is in intensive treatment environments, where it is assumed that the severity of the disorders treated is even higher. It is found that a combined program of individual and group Schema Therapy for Borderline Personality Disorder is effective in the inpatient setting. Subtle variations in treatment programs in three pilot studies leave room for the discussion of possible factors influencing treatment effects (paper 6). The results of all studies are discussed on the background of Schema Therapy’s development as a new psychotherapy approach for the treatment of complex disorders.
• Die vorliegende Dissertation stellt einen Beitrag zur empirischen Forschung im Bereich der Schematherapie dar. Auf der einen Seite wurde auf die Validierung eines schematherapeutischen Messinstruments, des Schema-Modus-Inventars (SMI), das sowohl im klinischen als auch im Forschungsbereich der Erfassung von Schemamodi dient, fokussiert. Auf der anderen Seite wurde die Manualisierung und Implementation therapeutischer Formate, wie Einzel- und Gruppentherapien sowie Kombinationsprogrammen, in der ST spezifiziert und schliesslich die Effektivität von ST, als intensivem stationären Behandlungsprogramm für Patienten mit Borderline Persönlichkeitsstörung, evaluiert...