The effectiveness of schema therapy for patientswith anxiety disorders, OCD, or PTSD : Asystematic review and research agenda

Objectives. We reviewed the evidence regarding the effectiveness of schema therapyfor anxiety disorders, obsessive-compulsive disorder (OCD), and posttraumatic stressdisorder (PTSD).

Methods. This systematic review followed the recommendation of the PRISMAguidelines. A database search (PsycINFO, MEDLINE, EMBASE, WEB OF SCIENCE, andAcademic Search Ultimate) was conducted to identify eligible studies up until 2 April 2021.The search included the keywords (‘schema therap*’ or ‘schema group therap*’or‘schema mode therap*’ or ‘schema focused’ or ‘young’s model’) and (‘anxiety disorder*’or ‘anxiety-related disorder*’ or ‘agoraphobia’ or ‘health anxiety’ or ‘phobi*’ or ‘panicdisorder’ or ‘obsessive compulsive disorder’ or ‘OCD’ or ‘posttraumatic stress’ or ‘posttraumatic stress’ or ‘PTSD’ or ‘hypochondria’ or ‘axis 1’). Included studies were appraisedon methodological quality according to the Psychotherapy Outcome study MethodologyRating Form.

Results. We identified 41 studies that were eligible based on the topic. However, onlysix (comprising 316 anxiety, OCD, and PTSD patients) could be included despite lenientmethodological inclusion/exclusion criteria. Results showed that schema therapy can leadto beneficial effects in disorder-specific symptoms and early maladaptive schemas. Yet, wealso uncovered substantial methodological limitations in most studies.

Conclusions. Schema therapy is a promising treatment for anxiety, OCD, and PTSD.Yet, there is a systematic problem in the quality of research despite growing clinicalinterest and application. We therefore concluded with a research agenda presentingrecommendations for future research that will be crucial for building a solid evidence-basefor schema therapy in chronic anxiety, OCD, and PTSD.