Mental health Mental and Behavioural Disorders
Conditions
Interventions
Cognitive Analytic Therapy (CAT) will be delivered by a qualified band 7 or 8 practitioner with appropriate core professional training (e.g., clinical psychologist) who has undertaken additional train
Sponsors
Greater Manchester Mental Health NHS Foundation Trust
Eligibility
Sex/Gender
All
Age
18 Years to 110 Years
Inclusion criteria
Inclusion criteria: 1. Aged 18 years or older 2. Three or more episodes of self-harm in the past year, confirmed via the Self-Injurious Thoughts and Behaviours Interview 3. Can be safely seen in an outpatient clinical context in which treatment is being provided as judged by their clinical team or referrer
Exclusion criteria
Exclusion criteria: 1. Participants will be excluded if they have a moderate-to-severe intellectual disability (IQ:< 70) affecting their eligibility for community mental health services as judged by their clinical team or referrer 2. Organic cerebral disease/injury affecting receptive and expressive language comprehension as judged by their clinical team 3. Non-English speaking to the degree that the participant is unable to answer questions and give written informed consent 4. Imminent and immediate risk to self or others, operationalised as the presence of active suicidal intent or planning to end one's life in the near future (e.g. next week). Where individuals are excluded on this basis, with the person’s consent, the researcher will aim to recontact them and the referrer in approximately one month’s time (or a time period agreed upon in collaboration with the individual) to determine if the risk has subsided to a point where they are now eligible. 5. Currently an inpatient 6. Experiencing a current, active episode of psychosis or mania 7. Currently receiving another active one-to-one psychological therapy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Measured using patient records: 1. Recruitment rates will be recorded across the 12 month recruitment period 2. Participant retention rate (completion of end-of-treatment follow-up assessments) will be recorded over 18 weeks (the length of time in the study) 3. Participant missing data on the primary outcomes (self-harm behaviour and urges) at assessment will be recorded over 18 weeks (the length of time in the study) 4. Adherence to treatment will be recorded as the percentage of participants receiving the minimum dose of therapy (=4 sessions) within the 10-week treatment window. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Self-harm measured with the Self-Injurious Thoughts and Behaviours Interview-Short Form (SITBI) at baseline, 12 weeks, and 18 weeks 2. Self-harm urges measured with the Alexian Brothers Urges to Self-Injure Scale (ABUSI) at baseline, 12 weeks, and 18 weeks 3. Dependence on self-ham measured with the experiences of Self-Injury Questionnaire Positive Beliefs subscale at baseline, 12 weeks, and 18 weeks 4. Personality structure measured with the Personality Structure Questionnaire at baseline, 12 weeks, and 18 weeks 5. Emotional distress measured with the Kessler Distress Scale at baseline, 12 weeks, and 18 weeks 6. Interpersonal problems measured with the Inventory of Interpersonal Problems-32 at baseline, 12 weeks, and18 weeks 7. Health status measured with the EQ-5D-5L at baseline, 12 weeks, and 18 weeks 8. Adverse experiences from therapy measured with the Adverse Experiences in Psychotherapy scale (AEP) at12 weeks | — |
Countries
England, United Kingdom
Outcome results
None listed