Psychotherapy for depression: a randomized clinical trial comparing schema therapy and cognitive behavior therapy

J Affect Disord. 2013 Nov;151(2):500-505. doi: 10.1016/j.jad.2013.06.034. Epub 2013 Jul 17.


Background: The efficacy of Cognitive Behavior Therapy (CBT) for depression has been robustly supported, however, up to fifty percent of individuals do not respond fully. A growing body of research indicates Schema Therapy (ST) is an effective treatment for difficult and entrenched problems, and as such, may be an effective therapy for depression.

Methods: In this randomized clinical trial the comparative efficacy of CBT and ST for depression was examined. 100 participants with major depression received weekly cognitive behavioral therapy or schema therapy sessions for 6 months, followed by monthly therapy sessions for 6 months. Key outcomes were comparisons over the weekly and monthly sessions of therapy along with remission and recovery rates. Additional analyses examined outcome for those with chronic depression and comorbid personality disorders.

Results: ST was not significantly better (nor worse) than CBT for the treatment of depression. The therapies were of comparable efficacy on all key outcomes. There were no differential treatment effects for those with chronic depression or comorbid personality disorders.

Limitations: This study needs replication.

Conclusions: This preliminary research indicates that ST may provide an effective alternative therapy for depression.

Keywords: CBT; Depression: RCT; Psychotherapy; Schema.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cognitive Behavioral Therapy
  • Depressive Disorder, Major / psychology
  • Depressive Disorder, Major / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psychotherapy*
  • Treatment Outcome