Treating complex PTSD with schema therapy, ImRs and EMDR: A review and case study
This case study evaluates the effectiveness of a combined therapy approach integrating ST, ImRs, and EMDR for treating CPTSD.
Article Abstract
“Introduction: Complex PTSD (CPTSD) often results from prolonged trauma, such as childhood abuse or domestic violence. Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) are recommended for treating PTSD. However, their limited effectiveness for CPTSD highlights the need for alternatives such as Schema Therapy (ST) and Imagery Rescripting. This case study evaluates the effectiveness of a combined therapy approach integrating ST, ImRs, and EMDR for treating CPTSD.
Method: A combination of Schema Therapy and EMDR was used. Treatment progressed in phases: Sessions 1–20 focused on building trust, case conceptualization (1–10) and reducing dysfunctional coping and Implementing Experiential Treatment (11–20). Sessions 21–40 were focused on trauma-focused therapy using a combination of ImRs and EMDR. The final phase (41–50) emphasized relapse prevention and was used as follow-up.
Results: Results showed notable reductions in maladaptive schemas, such as Unrelenting Standards/Hypercriticism and Detached Self-Soother and a decrease in the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) score from severe to below the clinical cut-off for PTSD.
Conclusion: While the patient’s case demonstrates promising outcomes, further research is needed to establish the efficacy of integrating ST, EMDR and ImRs for CPTSD. A randomized controlled trial is essential to compare this combined approach with each treatment separately and to explore the impact of treatment sequencing. Ultimately, optimizing therapy for CPTSD will require a personalized approach based on individual needs and responses.
Highlights:
- Effective Combined Therapy: This case study demonstrates the promising effectiveness of combining Schema Therapy (ST), Imagery Rescripting (ImRs), and EMDR to treat Complex PTSD (CPTSD), resulting in significant reductions in maladaptive schemas and a marked decrease in PTSD symptoms as measured by the CAPS-5.
- Importance of Personalized Treatment: The study underscores the need for a personalized approach to CPTSD, highlighting the value of adapting therapy based on the individual’s unique trauma history, emotional needs, and readiness for trauma-focused treatment.”
—Description from publisher
Article Access
Open Access
van Hemert, M. T. C., de Jong, P. M., Bouwer, T. R., Zoon, L., Gunst, E., Claes, L., & Morrens, M. (2025). Treating complex PTSD with schema therapy, ImRs and EMDR: A review and case study. European Journal of Psychotraumatology, 16(1), 2573616. Open access: https://doi.org/10.1080/20008066.2025.2573616
Date
October 29, 2025
Creator(s)
Mellony T.C. van Hemert, Paula M. de Jong, Tessa R. Brouwer
Contributor(s)
Luciano Zoon, Ellen Gunst, Laurence Claes, Manuel Morrens
Topics
Complex Trauma/C-PTSD
Practice & Methods
Integrative Therapies
Extent
12 pages
Publisher
Taylor & Francis
Rights
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
APA Citation
van Hemert, M. T. C., de Jong, P. M., Bouwer, T. R., Zoon, L., Gunst, E., Claes, L., & Morrens, M. (2025). Treating complex PTSD with schema therapy, ImRs and EMDR: A review and case study. European Journal of Psychotraumatology, 16(1), 2573616. Open access: https://doi.org/10.1080/20008066.2025.2573616
Audience
EMDR Therapists
Language
English
Content Type
Article, Peer-Reviewed
Access Type
External Resource, Open Access
