Purpose: Schema Therapy (ST), aiming to reduce maladaptive coping and increase healthy coping, is an intervention frequently offered in the Men’s Personality Disorder Service (MPDS). It is in the best interest of both service users and service providers to ensure treatment efficacy in achieving desirable outcomes. Evaluation enables services to understand how best to improve healthcare. The aim of this service evaluation is to determine whether ST demonstrates effectiveness in behaviour change by exploring changes in coping modes and institutional incidents.
Methods: Case notes of ten patients with a diagnosis of personality disorder, who completed the schema therapy programme were utilised. Content was analysed for evidence of coping modes. Frequencies of adaptive and maladaptive coping modes and institutional incidents were compared for six months pre- and post- intervention conditions. Qualitative analyses of behaviours were also conducted.
Results: As a group, large effect sizes were evident in the reduction in maladaptive coping modes, however there was no significant increases in healthy modes. When exploring each patients progress individually, six of ten patients showed a significant increase in healthy coping modes, and six of ten patients a significant reduction in maladaptive coping modes. No significant differences were found for institutional incidents.
Conclusion: ST is effective in changing frequencies of coping behaviours for some patients within the MPDS. Types of behaviours presented showed changes in all patients. Methodological implications and clinical utility are considered. Future evaluations should use a comparison group to be able to attribute behavioural changes directly to ST.
Keywords: Schema therapy, schema theory, service evaluation, personality disorder, clinical psychology, forensic psychology, content analysis, behaviour change, coping modes
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