The Effectiveness of Schema Therapy in Individuals Who Committed Crimes

Sousa, M., Gouveia, C., Cunha, O., & de Castro Rodrigues, A. (2024). The Effectiveness of Schema Therapy in Individuals Who Committed Crimes: A Systematic Review. Trauma, Violence & Abuse, 25(5), 3631–3642. https://doi.org/10.1177/15248380241254082 

Summary by: Joelle Shadi Fawaz Haddadin

Studies have shown that schema therapy is a promising therapeutic approach in several areas of psychology, including forensic psychology. In this paper, I will be reviewing a comprehensive systematic review conducted in 2024 by Sousa and colleagues, which assessed whether schema therapy is effective in reducing psychological symptoms as well as risk factors associated with criminal behavior among offenders. Out of an initial pool of 886 papers, the review identified 15 studies that met the inclusion criteria and analyzed their findings. The studies were found across multiple databases and were conducted in a variety of countries, with predominantly male participant pool.

Now, one may ask what sets schema therapy apart from the traditional Cognitive Behavioral Therapy (CBT) we are used to using in such cases. Well, schema therapy focuses on deeper underlying issues by exploring the emotional and developmental patterns that individuals develop, known as early maladaptive schemas (EMSs). In turn, this approach can help address the effects of traumatic experiences, impulsivity, and deeply ingrained personality patterns that may contribute to offending behavior.

The findings of the reviewed studies showed generally positive results. Offenders who received schema therapy often demonstrated reductions in early maladaptive schemas and maladaptive schema modes, as well as decreases in factors associated with criminal behavior, such as anger, paranoia, and cognitive distortions. Some studies also reported improvements in symptoms linked to personality disorders, including antisocial personality disorder and psychopathic traits, which is consistent with the theoretical literature on schema therapy.

Moreover, schema therapy didn't only reduce negative traits within these individuals but also helped develop some positive ones. For instance, studies observed improvements in emotional regulation, self-esteem, and interpersonal functioning. Additionally, one prominent example of the noticeable difference after intervention was seen in research conducted by Bernstein and colleagues, where offenders receiving schema therapy advanced more rapidly through forensic rehabilitation milestones compared to those receiving treatment as usual (TAU). Case studies included in the review also showed reductions in certain violence risk factors and improvements in interpersonal functioning, even within high-risk offender populations.

Schema therapy was also found to be promising in the form of schema therapy-based programs. The CONTIGO program, intended for intimate partner violence offenders, had a recidivism rate of 15.4% among participants who completed the program. However, this finding alone does not prove that the program prevented reoffending. Similarly, Portugal's Growing Pro-Social (GPS) program reduced anger, cognitive distortions, and early maladaptive schemas, with improvements maintained at a 12-month follow-up.

Nonetheless, the results weren't unanimous across all studies, and the review had some limitations that should be taken into consideration. The studies didn't all have the same research quality. Some used methodologically stronger randomized controlled trials, while others consisted of smaller samples and less consistent treatment protocols. One study found no significant improvements in most of the outcomes measured after treatment. Furthermore, several studies examined the same intervention program, and almost all participants were male, which limits how broadly the findings can be generalized. Hence, it would be beneficial for the field as a whole to conduct more high-quality trials and track long-term outcomes like recidivism.

Overall, this systematic review provides promising evidence for the effectiveness of schema therapy among offenders. By addressing deeply rooted maladaptive schemas and emotional and developmental patterns, this approach may help reduce personality disorder symptoms and risk factors associated with criminal behavior while improving emotion regulation. However, its effectiveness in preventing recidivism still needs further investigation.

This study offers only a glimpse into the potential effects of schema therapy on offenders, and more robust, larger-scale research is needed to confirm the results found in these studies. These findings suggest that schema therapy could not only help offenders manage their behavior but also support longer-term psychological change and potentially contribute to improvements in correctional rehabilitation programs.