Background: Group schema therapy is an emerging treatment for personality and other psychiatric disorders. It may be particularly suited to individuals with complex trauma given that early abuse is likely to create maladaptive schemas. Aims: This pilot study explored the feasibility and effectiveness of a 4-week in-patient group schema therapy programme for adults with complex trauma in a psychiatric hospital setting. Method: Thirty-six participants with complex trauma syndrome participated in this open trial. Treatment consisted of 60 hours of group schema therapy and 4 hours of individual schema therapy administered over 4 weeks. Feasibility measures included drop-out rates, qualitative interviews with participants to determine programme acceptability and measures of psychiatric symptoms, self-esteem, quality of life and schema modes pre-, post- and 3 months following the intervention. Results: Drop-out rate for the 4-week program was 11%. Thematic analysis of interview transcripts revealed four major themes: connection, mode language explained emotional states, identifying the origin of the problem and the emotional activation of the programme. Measures of psychiatric symptoms, self-esteem and quality of life showed improvement post-treatment and at 3 months post-treatment. There was a reduction in most maladaptive schema modes pre-/post-treatment. Conclusions: A group schema therapy approach for complex trauma is feasible and demonstrates positive effects on psychiatric symptoms and maladaptive schemas.

People with SMI have high levels of physical illness and significantly raised natural mortality compared to the general population. This is largely explicable by altered exposure to ordinary environmental risk factors and to poorer quality of medical treatment; partly because SMI can interfere with the individual's ability to organise their healthcare and partly because it can affect the quality of treatment delivered by professionals.

People with SMI can suffer the same range of physical illnesses as anyone else in the population but are at significantly greater risk of developing particular illnesses. Admission to a PICU presents an excellent opportunity for assessment and management of their physical health needs. PICU staff have a responsibility to develop effective mechanisms for identifying and treating acute physical illness, they also need to think about how best to address the detection and management of chronic physical illness and about their responsibilities in respect of health promotion.