{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:45:14Z","timestamp":1789778714370,"version":"4.0.1"},"reference-count":70,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":43,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Psychology and Psychoth"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Schema therapy (ST) is an effective psychotherapy for personality disorders in (older) adults. There is an increasing awareness of the imbalance in the ST community because of the emphasis on negative schemas versus attention to positive schemas. This study aimed to evaluate the effectiveness of an adapted ST approach that integrates positive schemas. Using a multiple baseline design, the study assessed 10 older adults (aged &gt;\u200960) with Cluster C personality disorders through 1\u2009year of weekly individual ST sessions, followed by a 6\u2010month follow\u2010up. Baseline consisted of 4\u20138\u2009weeks without intervention. Primary outcomes were credibility of positive and negative core beliefs; secondary measures examined symptomatic distress, schema modes, early maladaptive and positive schemas. Results showed mixed individual outcomes. Positive core beliefs significantly improved in 38% of participants during treatment and 50% at follow\u2010up, whereas negative core beliefs decreased significantly for 25% of participants during treatment and 67% at follow\u2010up. At the group level, significant increases with very large effect sizes were observed in positive core beliefs in baseline versus follow\u2010up and reductions in negative beliefs in baseline versus treatment and versus follow\u2010up. Secondary outcomes revealed significant reductions in symptomatic distress and PD criteria, alongside increased positive schemas. No significant changes were found for schema modes or maladaptive schemas. This first study underscores the potential of integrating positive schemas into ST for older adults, suggesting preliminary efficacy. Further research is essential to generalize findings across different age groups and diagnoses and to identify which aspects of positive schemas enhance therapy outcomes.<\/jats:p>","DOI":"10.1002\/cpp.70121","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T10:17:02Z","timestamp":1755080222000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Integrating Positive Schemas in Schema Therapy for Cluster C Personality Disorders in Older Adults: A Multiple Baseline Study"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1778-9637","authenticated-orcid":false,"given":"Loes","family":"van\u00a0Donzel","sequence":"first","affiliation":[{"name":"PersonaCura, Clinical Centre of Excellence for Personality Disorders and Developmental Disorders in Older Adults GGz Breburg  Tilburg The Netherlands"},{"name":"Tranzo Department Tilburg University  Tilburg The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0080-7464","authenticated-orcid":false,"given":"Machteld\u00a0A.","family":"Ouwens","sequence":"additional","affiliation":[{"name":"PersonaCura, Clinical Centre of Excellence for Personality Disorders and Developmental Disorders in Older Adults GGz Breburg  Tilburg The Netherlands"},{"name":"Tranzo Department Tilburg University  Tilburg The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7085-3349","authenticated-orcid":false,"given":"Sebastiaan\u00a0P.\u00a0J.","family":"van Alphen","sequence":"additional","affiliation":[{"name":"Department of Clinical and Lifespan Psychology Vrije Universiteit Brussel  Brussels Belgium"},{"name":"Clinical Centre of Excellence for Personality Disorders in Older Adults Mondriaan Mental Health Center  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1771-0546","authenticated-orcid":false,"given":"Samantha","family":"Bouwmeester","sequence":"additional","affiliation":[{"name":"TSB: Tilburg School of Social and Behavioral Sciences, Department of Developmental Psychology Tilburg University  Tilburg The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0746-2692","authenticated-orcid":false,"given":"Nathan","family":"Bachrach","sequence":"additional","affiliation":[{"name":"TSB: Tilburg School of Social and Behavioral Sciences, Department of Medical and Clinical Psychology Tilburg University  Tilburg The Netherlands"},{"name":"Department of Personality Disorders and Trauma Related Disorders GGZ Oost Brabant  Helmond The Netherlands"},{"name":"RINO Zuid  Eindhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2175-3453","authenticated-orcid":false,"given":"Arjan\u00a0C.","family":"Videler","sequence":"additional","affiliation":[{"name":"PersonaCura, Clinical Centre of Excellence for Personality Disorders and Developmental Disorders in Older Adults GGz Breburg  Tilburg The Netherlands"},{"name":"Tranzo Department Tilburg University  Tilburg The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2014.01.003"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119962830.ch30"},{"key":"e_1_2_9_4_1","volume-title":"Schema Therapy in Practice: An Introductory Guide to the Schema Mode Approach","author":"Arntz A.","year":"2017"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2022.0010"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.12040518"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/0000326-000"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/14999013.2012.746757"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119139980.ch41"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/17439760.2020.1818807"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1739-2"},{"key":"e_1_2_9_12_1","first-page":"3","volume-title":"Cognitive Therapy of Personality Disorders","author":"David D. O.","year":"2015"},{"key":"e_1_2_9_13_1","volume-title":"Brief Symptom Inventory 18\u2010BSI 18\u2010Handleiding Herziene Editie","author":"De Beurs E.","year":"2011"},{"key":"e_1_2_9_14_1","volume-title":"De Brief Symptom Inventory (BSI). De Betrouwbaarheid en Validiteit Van een Handzaam Alternatief Voor de SCL\u201090","author":"De Beurs E.","year":"2005"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.70080"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781003125600"},{"issue":"1","key":"e_1_2_9_17_1","article-title":"Using the Student's T\u2010Test With Extremely Small Sample Sizes","volume":"18","author":"De Winter J. C.","year":"2019","journal-title":"Practical Assessment, Research & Evaluation"},{"issue":"1","key":"e_1_2_9_18_1","first-page":"14","article-title":"Brief Symptom Inventory (Baltimore, Clinical Psychometric Research)","volume":"27","author":"Derogatis L.","year":"1975","journal-title":"Psychopathology"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.4324\/9780429350894"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbtep.2009.01.002"},{"key":"e_1_2_9_21_1","volume-title":"User's Guide for the SCID\u20105\u2010CV Structured Clinical Interview for DSM\u20105\u00ae Disorders: Clinical Version","author":"First M. B.","year":"2016"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1891\/0889-8391.25.4.257"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2020.103692"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1521\/ijct.2013.6.2.171"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2022.2158926"},{"key":"e_1_2_9_26_1","volume-title":"Single\u2010Case Research Designs: Methods for Clinical and Applied Settings","author":"Kazdin A. E.","year":"2011"},{"key":"e_1_2_9_27_1","unstructured":"Kazdin A. E. andA. H.Tuma.1982. \u201cSingle\u2010Case Research Designs.\u201d"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.2900"},{"issue":"1","key":"e_1_2_9_29_1","first-page":"12","article-title":"Randomization Tests for Single\u2010Case Educational Research","volume":"7","author":"Koehler M. J.","year":"1998","journal-title":"Journal of Modern Applied Statistical Methods"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.clinpsy.1.102803.144154"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465810000226"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781351171847-4"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10826-020-01807-0"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/bs14060443"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/00332941221100445"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1037\/pas0000567"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.3758\/BF03192707"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/00223891.2025.2454009"},{"key":"e_1_2_9_39_1","unstructured":"Overbeek T. K.Schruers andE.Griez.1999. \u201cMINI: Mini International Neuropsychiatric Interview Dutch Version 5.0. 0 (DSM\u2010IV).\u201d Maastricht: University of Maastricht 5."},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2010.08.006"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.4324\/9780203841709"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbtep.2015.12.001"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2013.05.011"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbtep.2004.08.005"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10826-016-0391-z"},{"key":"e_1_2_9_46_1","volume-title":"Positive Psychology: An Introduction","author":"Seligman M. E.","year":"2000"},{"issue":"20","key":"e_1_2_9_47_1","first-page":"22","article-title":"The Mini\u2010International Neuropsychiatric Interview (MINI): The Development and Validation of a Structured Diagnostic Psychiatric Interview for DSM\u2010IV and ICD\u201010","volume":"59","author":"Sheehan D. V.","year":"1998","journal-title":"Journal of Clinical Psychiatry"},{"key":"e_1_2_9_48_1","unstructured":"Sterk F. andM.Rijkeboer.1997. \u201cSchema\u2010Vragenlijst [Schema\u2010Questionnaire].\u201d Ambulatorium Utrecht University Utrecht the Netherlands."},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118468197.ch30"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10964-020-01289-9"},{"key":"e_1_2_9_51_1","first-page":"1","article-title":"Group Schema Therapy for Personality Disorders: Systematic Review, Research Agenda and Treatment Implications","author":"Tracy M.","year":"2024","journal-title":"Psychotherapy Research"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1572"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1521\/pedi.2023.37.2.262"},{"key":"e_1_2_9_54_1","unstructured":"van Donzel L. A. M.Claassen M. A.Ouwens et\u00a0al. Unpublished manuscript. \u201cPositive Constructs in Schema Therapy \u2010 A Scoping Review.\u201d"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.conctc.2021.100715"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.2964"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119962830"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(24)00001-1"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-019-1040-1"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610214001264"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2017.1318260"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1754470X21000325"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1521\/ijct.2017.10.1.62"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465820000077"},{"key":"e_1_2_9_65_1","article-title":"Permutation\u2010Based Testing for Single\u2010Case Experimental Designs","author":"VroegindeWeij R.","year":"2023","journal-title":"Behavior Research Methods"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmh.1434"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118468197"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.1010971"},{"key":"e_1_2_9_69_1","volume-title":"The Schema Mode Inventory","author":"Young J.","year":"2007"},{"key":"e_1_2_9_70_1","first-page":"63","article-title":"Young Schema Questionnaire","volume":"2","author":"Young J. E.","year":"1994","journal-title":"Cognitive Therapy for Personality Disorders: A Schema\u2010Focused Approach"},{"key":"e_1_2_9_71_1","volume-title":"Schema Therapy: A Practitioner's Guide","author":"Young J. E.","year":"2003"}],"container-title":["Clinical Psychology &amp; Psychotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cpp.70121","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cpp.70121","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cpp.70121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:22:03Z","timestamp":1772986923000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cpp.70121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":70,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/cpp.70121"],"URL":"https:\/\/doi.org\/10.1002\/cpp.70121","archive":["Portico"],"relation":{},"ISSN":["1063-3995","1099-0879"],"issn-type":[{"value":"1063-3995","type":"print"},{"value":"1099-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-02-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70121"}}