A Randomised Controlled Trial of the Efficacy of CAT for the Treatment of Personality Disorder

Clarke, S., 2001. A Randomised Controlled Trial of the Efficacy of CAT for the Treatment of Personality Disorder. Reformulation, ACAT News Autumn, p.x.


Background

Under the leadership of Professor Sue Clarke, a Randomised Control Trial of Cognitive Analytic Therapy is now underway at the Intensive Psychological Therapies Service (IPTS), Dorset. This aims to investigate the incremental benefit of CAT over and above standard NHS care in the treatment of patients with personality disorders.

The IPTS is an outpatient service for patients with a personality-disordered who have failed to benefit from previous psychological therapy. A multidisciplinary team offer a range of specialist treatments including Cognitive Analytic, Dialectical Behaviour and psychodynamic therapy. The IPTS has been awarded a NHS Beacon for being a model of quality practice.

Aims

The Structured Clinical Interview (SCID II, 1997) is used to confirm the presence of a DSM-IV Axis II Personality Disorder. Patients are then assigned randomly to receive a 24-session CAT or treatment as usual. Comparisons will be made on the following outcome indices: -

  • Psychometric measures of psychopathology (MCMI-III), dissociation (DIS-Q), global distress (CORE), interpersonal functioning (IIP-32) and personality fragmentation (PSQ).
  • Health service utilisation whilst participating in the trial.
  • Satisfaction with the services received (SSS-30).
  • Those receiving CAT will also complete a semi-structured interview at the end of therapy to assess the helpfulness of CAT.

Plan and Design

The trial began in May of this year. Nine patients have been randomised to receive immediate therapy and eight will wait nine-months whilst receiving treatment as usual. We hope to recruit 160 patients (80 in each condition) by May 2004.

Four accredited psychotherapists and three practitioners will deliver CAT under the supervision of Liz Fawkes. All sessions will be tape-recorded and a random sample will be rated for competency using the CCAT (Bennett, Parry and Ryle, 2000). This measure was described in the Autumn / Winter (2000) edition of ACAT news.

Further Information

For further information
please contact: -

Research Assistant
Intensive Psychological Therapies Service
Department of Psychological Therapies
51A Layton Road
Parkstone
Poole
BH12 2BJ

Tel: 01202 735300

E-mail: ipts@dorsethc-tr.swest.nhs.uk

Website: www.bournemouth.ac.uk/iptstest

References

American Psychiatric Association (1994) ‘Diagnostic and Statistical Manual of Mental Disorders’ (4th Edition), Washington DC: American Psychiatric Association

Attkisson C and Greenfield T (1994) ‘The Client Satisfaction Questionnaire-8 and the Service Satisfaction Scale-30 in M Maurish (Ed) ‘The use of psychological testing for treatment planning and outcome assessment’ pp402-420. Hillsdale, NJ: LEA

Bennett, Parry and Ryle (2000)

A Measure Of Cognitive Analytic Competencies For Use In Service Evaluation, Audit And Training

’ ACAT News, Autumn /Winter 2000

Connell J, Barkham M, Evans C et al (1998) ‘Clinical Outcomes in Routine Evaluation Systems Outcome Measure: Guidelines for use: Version 1.0’ London, CORE Systems Group

First M, Gibbon M, Spitzer R et al (1997) ‘Structured Clinical Interview for DSM-IV Axis II Personality Disorder. SCID II. American Psychiatric Press: Washington

Horowitz L, Rosenberg S, Baer B, Unreco G and Villasenor V (1988) ‘Inventory of Interpersonal Problems: Psychometric properties and clinical applications’ Journal of Consulting and Clinical Psychology (56) 885-892

Millon, T. Millon, C. & Davis, R. (1994) ‘Millon Clinical Multiaxial Inventory-III Manual’ Minneapolis, MN: National Computer Systems Inc.

Pollock P, Broadbent M, Clarke S and Ryle A in press The personality questionnaire: a measure of the multiple self-states model of identity disturbance in Cognitive Analytic Therapy in P Pollock (Ed)

Cognitive Analytic Therapy for Adult Survivors of Childhood Abuse: Approaches to Treatment and Case Management

’ Chichester: Wiley

Ryle, A. (1997)

Cognitive Analytic Therapy of Borderline Personality Disorder: The Model and the Method

’ Chichester: J. Wiley & Sons.

Vanderlinden J, VanDyck R, Vandereycken W, Vertommen H and Verkes R (1993) ‘The Dissociation Questionnaire (DIS-Q): Development and characteristics of a new self-report questionnaire’ Clinical Psychology and Psychotherapy (1) 21-27

Dr Sue Clarke

Full Reference

Clarke, S., 2001. A Randomised Controlled Trial of the Efficacy of CAT for the Treatment of Personality Disorder. Reformulation, ACAT News Autumn, p.x.

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