The SPeDi Trial (Sheffield Personality Disorders)

One of the main activities in the Psychological Therapies strand is a randomised controlled trial of psychotherapy for Borderline Personality Disorder (BPD). The trial is being conducted in the context of a new clinical service that has been developed by Sheffield Care Trust.

People with severe & complex psychological problems referred to by the label `borderline personality disorder´ experience acute distress and multiple difficulties – such as self-harm and repeated suicide attempts, panic, depression, anger problems and trouble with relationships. Our project aims to deliver and test improvements in services for people with these difficulties (who have at times been stigmatised and marginalised in mental health services). Mental health professionals, researchers and service users are working together to achieve this.

Two different approaches are being compared. People receive either care from a Community Mental Health Team whose team members have had special training, or psychological therapy. The therapy methods (cognitive behavioural or cognitive analytic) were pioneered in the UK. People coming into the project agree to be randomly allocated to one or the other, and are carefully followed up to find out how they get on in terms of improvements in their well-being, relationships and quality of life, using standardised measures. In addition, service users are collaborating on exploring the experiences people have in these services, whether helpful or unhelpful.

As well as improving provision for these clients, the project aims to answer several important research questions to inform future NHS services. Is it beneficial to offer individual therapy over and above good quality care from a CMHT? Which treatment programmes are most acceptable to service users? People in this client group often report negative experiences of care and many drop out of therapy, so it is important to focus on their experiences. In addition to service user involvement with the randomised trial, a parallel study addresses these issues directly, through qualitative methods. Other questions include which process factors predict outcomes, such as therapist competence, therapeutic alliance and specific techniques; and which client characteristics make a difference (e.g. history of early childhood abuse & trauma). To have a chance of answering these questions we need to follow up 132 people.

The trial service has recently recruited its first participants. To get useful evidence on which to plan services, we needed to set up a randomised trial in a realistic service setting and include the perspective of service users, which is usually neglected. This requires an extensive range of partnerships between care staff, therapists, researchers and service users, and development of an organisational culture within a mental health service to meet both clinical and research requirements.

http://www.shef.ac.uk/spedi/
 

ACAT Calendar for March
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11st March 2019
CPD Event: Research Conference - organised jointly by ACAT and Catalyse
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66th March 2019
CAT Introductory Event: ACAT: Two Day Introduction to CAT
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88th March 2019
CPD Event: ACAT: Out of control sexual behaviour
99th March 2019
CPD Event: CAT Nature Retreat - offered by CAT Cumbria
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CPD Event: How to run a successful private practice: all you need to know - offered by Become Psychology
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1515th March 2019
CPD Event: ACAT: CAT for psychosis: a relational approach
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1818th March 2019
Special Interest Group Event: CAT-TAST SIG meeting
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2727th March 2019
CPD Event: Trainers and Supervisors Meeting
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2929th March 2019
CPD Event: ACAT: CAT with Couples
CPD Event: Forensic CAT Conference - offered by Tees, Esk and Wear Valley NHS Trust (TEWV)
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More information:

Support for CAT research Current Research and Research Awaiting Publication Deconstruction of CAT Using a CAT approach to make sense of psychosis Team based Interventions with 5 session CAT consultancy The case formulation task in psychotherapy Therapists’ Construction and Application of the Reformulation Diagram in Clinical Practice RCT of CAT with adolescent and borderline patients Understanding SDRs in CAT CAT Sequential Diagrammatic Reformulation (SDR) to explore service users' experience of CAT formulation: a qualitative thesis project Comparison of Treatment of Anorexia in Adults with CAT Case Series Research - in intellectual disability (community and forensic) services Recently Published Research and Research Presentations A Feasibility Trial of Group Cognitive Analytic Music Therapy in Secure Hospital Settings (2014) Assessment of identity disturbance: Factor Structure and validation of the Personality Structure Questionnaire (PSQ) in an Italian sample CAT and Psychosis Cognitive Analytic Therapy for high-risk sexual behaviour Is Cognitive Analytic Therapy (CAT) effective in treating Hoarding Disorder? Testing the Effectiveness of Cognitive Analytic Therapy for Hypersexuality Disorder: An Intensive Time-Series Evaluation Group Cognitive Analytic Therapy for Female Survivors of Childhood Sexual Abuse An eight-eyed version of Hawkins and Shohet’s clinical supervision model: the addition of the cognitive analytic therapy concept of the ‘observing eye/I’ as the ‘observing us’ Outcomes of cognitive analytic therapy delivered by trainees Treatment of Paranoid Personality Disorder with Cognitive Analytic Therapy - A Mixed Methods Single Case Experimental Design Team Consultancy Using Cognitive Analytic Therapy: A Controlled Study In Assertive Outreach Using a cognitive analytic approach to formulate a complex sexual and violent offender to inform multi-agency working: developing a shared understanding Bipolar Trial: CATBiD: A phase one randomised controlled study of Cognitive Analytic Therapy for Bipolar Affective Disorder Development and evaluation of cognitive analytic guided self-help (CAT-SH) for use in IAPT services How change is enabled during cognitive analytic therapy: An exploratory study of the treatment of depression Key References to Research in CAT Summaries and Meta-analyses of CAT Research Cognitive Analytic Therapy at 30 Cognitive Analytic Therapy: A review of the outcome evidence base for treatment summaries and meta analyses Research and Communication Committee ACAT Research Strategy Donate to ACAT Research Fund Researchers Currently Recruiting Through ACAT CAT Research Archives Do people with learning disabilities have a concept of reciprocal roles Exploring endings from therapist's experience RCT for CAT and diabetes A process study evaluating rupture repair in CAT CAT in groups The SPeDi Trial (Sheffield Personality Disorders) Goodbye Letters in CAT The effectiveness of CAT for BPD RCT for CAT informed care planning CAT and CBT for affective disorders

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