Integrating Chair Work and Acceptance and Commitment Therapy in Eating Disorders: A Practice-Based Perspective on Dysfunctional Schema Modes and Psychological Flexibility: doi: 10.7417/CT.2026.2151
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: Eating disorders are often resistant to conventional therapeutic interventions because of entrenched dysfunctional schema modes that are automatically activated in stressful situations. This study aimed to evaluate the effectiveness of an integrative therapeutic approach combining the Chair Work Technique from Schema Therapy with Acceptance and Commitment Therapy (ACT) interventions for modifying dysfunctional schema modes in individuals with eating disorders. A quasi-experimental pretest-posttest study involved 167 participants (152 women and 15 men) aged 18–35 diagnosed with eating disorders. Between October 2024 and July 2025, participants completed a structured therapeutic program integrating Chair Work, cognitive defusion, and value-oriented interventions. The findings demonstrated substantial clinical and psychological improvements. The proportion of participants with clinically significant eating disorder symptoms decreased from 95.8% to 23.9%, while depressive symptoms decreased by 48.7%, with large effect sizes (Cohen’s d = 1.67 and 1.46). Significant structural changes in schema modes were also observed: the Healthy Adult mode increased from 3.6% to 82.6%, whereas the Demanding Critic mode decreased from 52.7% to 6%, and the Detached Protector mode from 26.9% to 6.6%. Psychological flexibility increased by 71%, from M = 21.55 to M = 36.89. The integrative protocol promoted not only symptom reduction but also structural reorganisation of personality functioning through the development of metacognitive awareness and value orientation. The results support the potential of this approach for developing differentiated and digital therapeutic interventions aimed at improving access to specialised treatment for eating disorders.
Source: La Clinica Terapeutica
Author: Martsyniak-Dorosh, Oksana
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: diamond
OpenAlex ID: W7224073417