Schema Therapy for adolescents with personality disorder traits and disruptive behavior problems in secure residential youth care

This study investigates the effectiveness of Schema Therapy in adolescents with disruptive behaviors and personality disorder traits in secure residential care. Treatment co-ordinators ask patients, who are ready for the transfer from a high secure observational unit to a medium secure treatment unit, and their parents for informed consent. For practical reasons, we use a "natural randomisation" procedure to allocate participants to either the Schema Therapy or Treatment as Usual (TAU) condition: Participants are transferred to one of two Schema Therapy units when there is a bed available, and when a Schema Therapist can start the individual Schema Therapy within 6 weeks. If either one of these conditions is not met, then the participant is transferred to a TAU unit. An independent commission assesses the availability of beds and therapy sessions, which is blind to both researchers and treatment co-ordinators. Self-report measures on behavior problems, personality pathology, and quality of life are administered right after transfer to a medium secure unit and every three months after that. Follow-up measures are administered three and twelve months after discharge from secure residential youth care.

Schema Therapy outperforms treatment as usual with respect to improvement in behavior problems, personality pathology, and quality of life.

right after inclusion in study and transfer to medium secure treatment units, and then every three months during stay at medium secure unit. Follow-up both 3 and 12 months after discharge.

Schema Therapy (individual Schema Therapy and treatment climate based on Schema Therapy principles)

Treatment as usual (individual cognitive-behavioral therapy / training or and treatment climate based on behavioral principles)