Group schema therapy in non-responding patients with common mental disorders: a pilot study

• Group schema therapy (ST) appears to be a feasible and potentially effective treatment for non-responding patients with anxiety, depression, obsessive compulsive-, or somatoform disorders. • Dropout rates were moderate, and participant satisfaction was high, indicating strong acceptability and engagement of group-ST within this population. • After group ST, significant improvements were observed in anxiety, depression, and disability, with sustained benefits over time. • Further controlled research is needed to confirm whether these improvements can be attributed to the ST intervention. Common mental disorders such as anxiety, depressive, and somatoform disorders often have a chronic course, with a substantial proportion of patients not responding adequately to standard treatments. Dysfunctional personality traits appear to contribute to treatment resistance. Schema therapy (ST) targets early maladaptive schemas and has proven effective for personality disorders. This pilot study examines the feasibility and outcome of group ST for non-responding patients with common mental disorders. Seventy-nine outpatients with anxiety, obsessive-compulsive, depression, or somatoform disorders who had not responded sufficiently to prior treatment, participated in this study. A six-week ST introduction group was offered, followed by a diagnosis-specific ST group for up to 30 weeks. Feasibility was assessed through dropout rates and the Client Satisfaction Questionnaire (CSQ-8). Clinical outcomes were measured using the Beck Anxiety Inventory (BAI), the Patient Health Questionnaire (PHQ-9), and the World Health Organization Disability Assessment Schedule (WHODAS 2.0), before and after treatment and at three month follow up. Dropout rates were moderate, and participant satisfaction was high, indicating strong acceptability and engagement. Significant improvements were observed in anxiety, depression, and disability, with benefits persisting at 3 months after treatment. The non-controlled design limits causal conclusions. Also, mechanisms of change remain unclear. Although controlled for, high rates of missing data weaken the robustness of findings. These findings suggest that group-ST may be a feasible and potentially effective treatment for non-responding patients and are consistent with prior evidence indicating that schema therapy could have broader applicability beyond personality disorders.