Schema therapy for Dissociative Identity Disorder (DID): a repeated case series

Background: Research on treatment options for patients with Dissociative Identity Disorder (DID) is limited and primarily focuses on phase-based psychodynamic treatment. Objective: This study evaluated the effectiveness of an adapted Schema Therapy (ST) model for patients with DID. Method: A Non-Concurrent Multiple Baseline Case Series Design (N = 10) was employed, in which patients served as their own controls. Results: Mixed regression indicated that ST significantly reduced high-frequently-assessed dissociative symptoms with a medium effect size. Six out of ten participants lost their DID diagnosis and treatment drop-out was 20%. The secondary outcome results (low-frequency assessments from pre-treatment to follow-up one year after the end of treatment) corroborated these findings, indicating large effect sizes for the reduction of dissociative symptoms and dissociation-related dysfunctional beliefs and medium effect sizes for PTSD symptoms and overall disability. Moreover, a decrease in maladaptive modes and an increase in the adaptive modes were seen. Finally, large effect sizes were observed for both therapist- and patient-indicated progress in treatment. Conclusions: The results suggest that the investigated ST protocol may be associated with improvements across multiple symptom domains and warrant further investigation as a treatment approach for DID. Patients who had undergone schema therapy showed statistically significant reductions in dissociative symptoms.The results indicated medium to large improvements on multiple secondary outcomes.By exceptionally intense monitoring, detailed insight is available on the patients followed. Patients who had undergone schema therapy showed statistically significant reductions in dissociative symptoms. The results indicated medium to large improvements on multiple secondary outcomes. By exceptionally intense monitoring, detailed insight is available on the patients followed.