Relational Approach to Treating Self-Harm (RelATe)
Research type
Research Study
Full title
Relational Approach to Treating Self-Harm (RelATe): A Feasibility Study of Cognitive Analytic Therapy for People who Self-Harm
IRAS ID
318068
Contact name
Peter Taylor
Contact email
Sponsor organisation
Greater Manchester Mental Health NHS Foundation Trust
ISRCTN Number
ISRCTN75661422
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Research Summary:
Self-harm refers to when a person intentional harms themselves, for example by cutting themselves or taking an overdose. Self-harm can occur both with and without suicidal intent. Research suggests that in the UK rates of self-harm have increased. It is a major health concern because self-harm is associated with a greater risk of suicide and emotional distress. Evidence of which therapies are most helpful for people who self-harm is limited. Some therapies that are currently used are also very intensive, can be difficult to access, and do not suit everybody. Cognitive Analytic Therapy (CAT) is a talking therapy that has the potential to help people who self-harm. It may provide a helpful alternative for people struggling with self-harm that may not be eligible for or able to access other therapies. Before a large-scale clinical trial of CAT for self-harm can be undertaken, it is helpful to conduct a smaller-scale feasibility trial. The aim of the current study is therefore to undertake a feasibility randomised controlled trial (RCT) of CAT for adults who self-harm. Data will be collected to help answer important feasibility uncertainties (e.g. can we recruit and adequate sample).The trial will aim to recruit 60 adults with experiences of self-harm from NHS mental health services, including IAPT (Improving Access to Psychological Therapy) services and other community-based mental health services. Participants would be randomly allocated to either receive their usual treatment, or receive eight sessions of CAT plus their usual treatment. Participants will be invited to complete assessments at the study start, and 12 and 18 weeks after they have been randomly allocated to a group. Assessments will capture important clinical outcomes, and data will also be collected on recruitment and attendance rates. Participants will also be interviewed about their experience of taking part in the trial.
Summary of Results:
Self-harm is a prevalent health problem in the UK. People who self-harm are at greater risk of suicide and emotional difficulties. Currently there is a lack of dedicated services to help people who self-harm. Many people who self-harm feel they are “passed from pillar to post”, being seen as too complex for some therapies but not be eligible for others. There is therefore a gap in mental health services, where a therapy to help people who self-harm would be beneficial. Cognitive Analytic Therapy (CAT) is a talking therapy with a rapidly a growing evidence base, that could fill the current gap in self-harm therapies. CAT would work by helping a person to notice the psychological patterns behind their self-harm, and in collaboration with the therapist build a different, more positive relationship with themselves where self-harm is no longer needed.
We ran a feasibility study, which was designed to tell us whether a larger clinical trial of CAT for people who self-harm is possible, by checking details such as whether people take part and attend appointments.Adults with recent self-harm took part. They were put into two groups at random, to receive usual treatment alone or 8 sessions of CAT plus usual treatment. We assessed participants’ current difficulties at the start of the study, 12 weeks after randomisation, and 18 weeks after randomisation. We also interviewed a subgroup of participants about their experiences.
We were able to recruit 60 people to take part and had good rates of people attending assessments and therapy appointments. In interviews participants said that the therapy felt helpful to them. The results suggest a larger trial to tell us whether CAT is effective in helping this group of people is feasible and should be the next step.REC name
North West - Greater Manchester West Research Ethics Committee
REC reference
22/NW/0317
Date of REC Opinion
7 Nov 2022
REC opinion
Further Information Favourable Opinion