Group schema therapy for patients with severe anxiety disorders

Abstract

This article presents an adaptation of group schema therapy (GST) developed for patients with severe anxiety. An anonymized case presentation exemplifies the adaptation. GST was originally developed to treat clients with maladaptive personality traits but has been applied to a variety of disorders in recent years. For patients with severe anxiety, who have not responded to other treatments, GST may be a promising approach. The paper presents the GST model, the evidence supporting it, and its adaptation for the treatment of anxiety. The case presentation illustrates the therapeutic process and GST interventions. Finally, the clinical outcome and the implications for implementing GST are discussed.

Structured group psychotherapies: Advantages, challenges, and possibilities

“…Maladaptive schemas are also an explicit target of group schema therapy for severe anxiety disorders (Straarup et al, 2022). Provided over 18 group sessions, this treatment systematically focuses on schemas reflecting early childhood interactions with caregivers.…”

Beyond treatment modalities: Clinical decisions and relational dynamics that facilitate change in group treatments

“…Second, once a group treatment is identified, there remains the question of how and if complementary individual sessions are helpful/needed. Patients in four of the six described group treatments in this issue also participated in individual therapy sessions in addition to their group sessions (Cheli et al, 2022; Inchausti et al, 2022; Juul et al, 2022; Straarup et al, 2022). The individual sessions were typically conducted at the beginning of treatment to develop a case formulation, with a couple of additional sessions to supplement the group or help with termination (Inchausti et al, 2022; Straarup et al, 2022).…”

“…Patients in four of the six described group treatments in this issue also participated in individual therapy sessions in addition to their group sessions (Cheli et al, 2022; Inchausti et al, 2022; Juul et al, 2022; Straarup et al, 2022). The individual sessions were typically conducted at the beginning of treatment to develop a case formulation, with a couple of additional sessions to supplement the group or help with termination (Inchausti et al, 2022; Straarup et al, 2022). In one case, several months of individual sessions were conducted before the start of the group (Cheli et al, 2022) or individual sessions were interspersed with group sessions every other week (Juul et al, 2022).…”

“…In the case examples presented, three of the studies reported on recruitment for therapy groups based on specific symptom presentations: borderline personality disorder, avoidant personality disorder, and clinical levels of perfectionism (Cheli et al, 2022; Inchausti et al, 2022; Juul et al, 2022). One group, GST, was designed for individuals with anxiety disorders who may share common traits but do not necessarily have the same disorder (Straarup et al, 2022). Two other groups, CPF and FGAP, included individuals with varying presenting problems (Griner et al, 2022; Lorentzen, 2022).…”

“…1.1 | Group Schema Therapy (GST): The case of Amy Straarup et al (2022) examined the process of GST for individuals with anxiety disorders who had not adequately responded to a prior course of cognitive-behavioral treatment. The authors hypothesized that attending more directly to core beliefs and schemas might provide additional benefit above and beyond targeting current symptoms.…”