CATCH-Y: A Feasibility Trial
Research type
Research Study
Full title
A Case-Series of a Brief CAT-Informed Intervention for Young People who self-injure (CATCH-Y)
IRAS ID
287611
Contact name
Peter Taylor
Contact email
Sponsor organisation
The University of Manchester
Clinicaltrials.gov Identifier
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
1 years, 4 months, 1 days
Research summary
Summary of Research
Non-suicidal self-injury (NSSI), the term used for when somebody purposefully hurts themselves without intending to end their life. Often, it suggests that there are other difficulties going on in someone’s life. Talking therapies can be offered to help. Currently there is little evidence to show which therapies help most. CATCH-Y (Cognitive Analytic Therapy for Containing Self-Harm in Young People) is a brief talking therapy which has been created to support young people who self-injure. It aims to help young people and those around them develop a shared understanding of their difficulties.The aim of the study is to examine the feasibility (e.g. is it possible to conduct a study about this intervention) and acceptability (do participants find the therapy is helpful and makes sense to them) of the CATCH-Y intervention. As a secondary measure, we are looking at whether CATCH-Y shows preliminary evidence for positive change on relevant measures of psychological difficulties (e.g. distress, how young people feel about themselves and others).
The current study will aim to recruit nine young people who have self-injured in the past. Participants must be aged between 13 - 17 years old and have self-injured within the last six months. They will be recruited from local Child and Adolescent Mental Health Services (CAMHS). The therapy is five sessions long. Participants will be asked to complete assessments before and after the therapy. Online assessments will also be completed throughout and for four weeks after the therapy has finished. Information on attendance rates and missing data will also be recorded.
The findings from this study will help to develop the therapy and improve further testing in larger studies. If this is successful, CATCH-Y could be available as a treatment for young people who self-injure.
Summary of Results
What was the study about?
Self-injury refers to when a person hurts themselves on purpose, for example by cutting or hitting themselves. It is common in young people aged 13-17 years old. Talking therapies can be offered to help. There is little research evidence to show which therapies help most. Self-injuring is often considered a way of coping with emotional and relational difficulties. In our study, we wanted to look at ways of helping young people who self-injure. One therapy that could help is called Cognitive Analytic Therapy (CAT). The therapy looks at individual’s relationship with themselves and other people and helps to understand problem patterns. Previously, a brief intervention using ideas from CAT has been helpful for adults who self-injure. Our study was based on five sessions of CAT-informed therapy and we called it CATCH-Y. This was a new intervention and we wanted to see whether it could be helpful for young people who self-injure.When we try to find out if a therapy is helpful or not, there are lots of important questions we need to answer. Often the question we are most interested in is, does the therapy work? However, before we can answer this, there are other questions we have to answer first. These questions are usually about Feasibility – is it even possible to do a study about this therapy? Will people take part? Can we get the data we need? We also have important questions about Acceptability – what do young people think about the therapy? Do young people attend the therapy sessions? In this study our main aim was to answer these questions about feasibility and acceptability.
What did we do?
We recruited 13 young people for the study, aged 13-17 years old. They had all self-injured in the past six months. Young people were recruited from two Children and Adolescent Mental Health Services (CAMHS) and there was a mix of females and males from a range of backgrounds. They were offered three assessment sessions and five-therapy sessions. In the therapy sessions, we aimed to build a shared understanding of why the young person might self-injure. We explored their past and current experiences and made links to their self-injury. We also looked at ways of helping them to manage some of these difficulties. In the last session, we aimed to invite a key worker and sometimes a family member, if the young person agreed; so that we could share the understanding we had built. The idea of this last session was that this could help guide the future support or help the young person was offered.Questionnaires were completed before, during and after the therapy. We also collected information about how many sessions young people attended, and what they thought of the therapy. This sort of information is really important in telling us if the therapy or the way we research it needs changing in some way.
What did we find?
All of the participants attended all five of their therapy sessions. Most participants completed the questionnaires before and after the therapy. The rates of completion on the weekly measures were lower. The results suggested that the majority of young people found the therapy helpful and formed a positive relationship with their therapist. We found that participants’ mood got better, but urges to self-harm stayed the same. There was a reduction in participants’ motivation to change but an improvement in their outlook and sense of recovery.Young people also completed an alternative outcome measure, called a repertory grid. The measure aimed to gather information about more meaningful and personal change. The repertory grids were completed before and after completion of CATCH-Y. We were unsure whether young people would find repertory grids easy to complete, due to their reflective approach. However, we found that most young people were able to complete a repertory grid. The measure showed that after the therapy most young people felt more positive about themselves than they did before. They also viewed themselves more similar to people their cared about.
Unfortunately, there were a small number of young people found the therapy difficult. Young people who were more able to talk about their emotional and relational experiences seemed to benefit more from a short-term therapy. However, overall, the therapy seemed to be liked by most young people. There were also signs of positive changes.
What next?
With this kind of study it is hard to say for sure if it was the therapy that helped or other factors we might not be aware of. In research, finding out for sure if a therapy can help people is a very difficult question to answer, and requires much larger studies, often with hundreds of people taking part. However, this study is still a really important step. It tells us that the therapy has promise, and that it is feasible for us to start to run bigger studies about this approach. The next step for this research would be for us to apply to run a larger study, called a clinical trial, that will look more closely at this type of therapy and whether it could help young people who self-injure.REC name
North West - Preston Research Ethics Committee
REC reference
21/NW/0019
Date of REC Opinion
24 Feb 2021
REC opinion
Further Information Favourable Opinion