Does Five Session CAT Consultancy Lead to Improved Outcomes?

Study Overview
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Brief Summary
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Five session CAT (Cognitive Analytic Therapy) consultancy was developed for patients whom services 'struggle to help', such as those with diagnoses of personality disorder. Five session CAT consultancy works with both patients and care coordinators, utilising key elements of CAT including reciprocal roles and reformulation to inform care planning and case management. The proposed study expands on the existing evidence base by utilising a comparator; a treatment as usual condition. The proposed mixed methods feasibility study will compare outcomes for both patients and care coordinators to assess the effectiveness of the intervention compared to controls in a community mental health team.

Official Title
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Does Five Session CAT (Cognitive Analytic Therapy) Consultancy Lead to Improve Outcomes for Patients and Care Coordinators?

Conditions
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Psychological Intervention, Treatment as Usual

Intervention / Treatment
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* Other: Five session cognitive analytic therapy (CAT) consultancy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: they are indicated as unsuitable for individual therapy, there is a poor or challenging relationship between the patient and the care coordinator(s) the care coordinator(s) feels a sense of 'stuckness' with the case the patient is chaotic Exclusion Criteria: actively psychotic severely misusing substances have poor appointment attendance indicating that they are actively suicidal and unwilling to commit to trying to stay safe.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: The study will utilise two conditions - intervention and waiting list. Participants on the waiting list will then proceed to the intervention condition.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br> | Other: Five session cognitive analytic therapy (CAT) consultancy<br>* Five session consultancy with patients and care coordinators using cognitive analytic therapy<br>|
| No Intervention: Treatment as usual (waiting list control)<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Personality Structure Questionnaire (PSQ) | Primary outcome measure for patients utilised to measure change across multiple time-points. The PSQ is an 8-item measure of identity disturbance. Each item is rated using a 5-point Likert scale. The maximum score on the scale is 40, indicating a high level of identity disturbance. | Screening (point of referral), start of waiting list (up to 2 weeks), end of waiting list (up to 12 weeks), start of treatment (up to 12 weeks), end of treatment (up to 22 weeks), 8 week follow-up (up to 30 weeks), 12 week follow-up (up to 34 weeks) | 
| Perceived competence scale | Primary outcome measure for care coordinators utilised to measure change across multiple time-points. The Perceived Competence Scale is a four item Likert-scale ranging from 1 to 7. The maximum score for each item is 7, and the maximum overall score for the scale is 28, indicating the highest levels of perceived competence. | Screening (point of referral), start of waiting list (up to 2 weeks), end of waiting list (up to 12 weeks), start of treatment (up to 12 weeks), end of treatment (up to 22 weeks), 8 week follow-up (up to 30 weeks), 12 week follow-up (up to 34 weeks) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical Outcomes in Routine Evaluation (CORE-10) | Secondary outcome measure for patients utilised to measure change across multiple time-points. The CORE-10 is a ten item questionnaire which measures psychological distress. The maximum score on this measure is 40, indicating the highest level of psychological distress. | Screening (point of referral), start of waiting list (up to 2 weeks), end of waiting list (up to 12 weeks), start of treatment (up to 12 weeks), end of treatment (up to 22 weeks), 8 week follow-up (up to 30 weeks), 12 week follow-up (up to 34 weeks) | 
| Working Alliance Inventory Short-Revised (WAI-SR) | Secondary outcome measure for patients utilised to measure change across multiple time-points. The WAI-SR is a 12 item scale; items are rated using a 5-point Likert scale. The items can be divided into three constructs, measuring goals, tasks and bond. Each of these domains have scores ranging from 5 to 20. Higher scores indicate better working alliance. | Screening (point of referral), start of waiting list (up to 2 weeks), end of waiting list (up to 12 weeks), start of treatment (up to 12 weeks), end of treatment (up to 22 weeks), 8 week follow-up (up to 30 weeks), 12 week follow-up (up to 34 weeks) | 
| Doubt Subscale of the Mental Health Professionals Stress Scale (MHPSS) | Secondary outcome measure for care coordinators utilised to measure change across multiple time-points. The doubt subscale is a six-item scale which measures professionals' doubt about their practice. Each item will be scored as 1 if present with a maximum score of 6, indicating high levels of doubt. | Screening (point of referral), start of waiting list (up to 2 weeks), end of waiting list (up to 12 weeks), start of treatment (up to 12 weeks), end of treatment (up to 22 weeks), 8 week follow-up (up to 30 weeks), 12 week follow-up (up to 34 weeks) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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psychology, cognitive analytic therapy