Cognitive analytic therapy-guided self-help for depression: A mixed methods evaluation

To evaluate cognitive analytic therapy-guided self-help (CAT-GSH) for depression in terms of outcomes and acceptability.

A parallel mixed methods case series with session-by-session outcome measurement supplemented by patient and staff interviewing.

Four psychological well-being practitioners (PWPs) delivered CAT-GSH to N = 11 patients in an NHS talking therapies service, and these patients were followed up at 1 month. Acceptability of CAT-GSH was assessed via treatment refusal and dropout rates, sessional attendance and qualitative interviewing of PWPs and patients. Outcomes were assessed by comparing group means at screening, termination and follow-up on sessional measures, calculating the case-by-case recovery rate and benchmarking against relevant research.

All 11 patients offered CAT-GSH accepted; one patient dropped out, all completers attended the full 6 sessions, and 7/10 were in reliable recovery at follow-up. Treatment gains were maintained over the follow-up period, and outcomes appeared equivalent when benchmarked against the evidence base. Patients found CAT-GSH to be a mostly acceptable intervention, and this was due to mood improvements, better recognition skills and implementation of 'exits'. CAT-GSH improved the diversity of the treatment offer for PWPs and provided professional development opportunities.

CAT-GSH holds promise as a low-intensity treatment for depression, but clearly more controlled research is needed.