(PS3-72) How Do Early Maladaptive Schemas Impact the Therapeutic Relationship?

Background: Research consistently supports the therapeutic relationship as a significant mechanism in symptom change, with a positive alliance predicting improved outcomes in psychotherapy (Baier, Kline, & Feeny, 2020). The therapeutic relationship consists of the interpersonal relationship between the therapist and patient, and is affected by a multitude of factors including personality factors (e.g. agreeableness, consciousness, neuroticism; Bucher, Suzuki, & Samuel, 2019). Young (2003) described early maladaptive schemas (EMS) as persistent, dysfunctional emotional and cognitive patterns which impact how the individual interacts with themselves, others, and the world (Young et al., 2003). EMS are positively associated with interpersonal problems. Specifically, the disconnection and rejection schema domain shows the greatest negative impact due to difficulties forming secure attachments to others (Janovsky et al., 2020). While prior research has demonstrated the impact of EMS on interpersonal relationships, the connection between EMS and the therapeutic relationship remains unclear. The current study aims to address this gap by evaluating the association between EMS and the therapeutic relationship in order to inform effective interventions when working with individuals endorsing EMS.

Method: Participants will consist of approximately 15 adults presenting for treatment at the Anxiety and Depression Clinic (ADC), and their respective student-therapists, within Hofstra University’s Clinical Psychology Department. All participants will be at least 18 years of age and have a primary anxiety and/or depressive disorder diagnosis. Exclusion criteria include presenting with current psychotic symptoms and/or substance use disorders. After informed consent, participants will complete The Young Schema Questionnaire Short Form Version 3 (YSQ-S3; Young & Brown, 2005) and provide demographic information as a part of standard intake procedures. Subsequently, participants will begin CBT and changes in the therapeutic relationship will be assessed every six weeks for 18 weeks. Specifically, participants will complete the Scale to Assess the Therapeutic Relationship - Patient version (STAR-P), and their respective therapists will complete the Scale to Assess the Therapeutic Relationship - Clinician Version (STAR-C; McGuire-Snieckus et al., 2007). 

Data Analysis Plan: A series of regressions and ANOVAs will be conducted to assess connections between EMS and the therapeutic relationship. To clarify, mean total scores on the STAR-P and STAR-C will represent therapeutic relationship rating and serve as the outcome of interest. In turn, presence/absence of EMS domains and total number of endorsed EMS at intake will be examined as potential predictors of therapeutic relationship rating.